青光眼對(duì)角膜內(nèi)皮的影響課件

青光眼對(duì)角膜內(nèi)皮的影響EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL青光眼對(duì)角膜內(nèi)皮的影響1「正常角膜內(nèi)皮的形態(tài)特定的細(xì)胞鑲嵌結(jié)構(gòu)單層六邊形細(xì)胞形態(tài)和大小相當(dāng)一致EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL「正常角膜內(nèi)皮的形態(tài)2隨年齡增長(zhǎng)角膜內(nèi)皮會(huì)如何呢細(xì)胞的多型性日趨明顯細(xì)胞體積變大內(nèi)皮細(xì)胞總數(shù)和六角形細(xì)胞減少,六角形細(xì)胞仍是主要形態(tài)的細(xì)胞(>57%EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL隨年齡增長(zhǎng)角膜內(nèi)皮會(huì)如何呢3廣愈合儲(chǔ)備”(擴(kuò)展?jié)摿?維持角膜的透明的關(guān)鍵環(huán)節(jié)當(dāng)細(xì)胞隨年齡增長(zhǎng)而不斷凋亡或是受到損害時(shí),主要是通過(guò)周圍正常細(xì)胞的增大、擴(kuò)展和滑行移動(dòng)來(lái)覆蓋、填充、鋪平缺陷區(qū)域EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL廣愈合儲(chǔ)備”(擴(kuò)展?jié)摿?4對(duì)角膜內(nèi)皮正確評(píng)估的重要性當(dāng)內(nèi)皮層失去其六角形正常結(jié)構(gòu),非六角形細(xì)胞增加將使其處于不穩(wěn)定狀態(tài),導(dǎo)致屏障功能下降人類角膜內(nèi)皮細(xì)胞不能再生,由此眼科疾病或眼部手術(shù)、創(chuàng)傷均可使丟失加快防止角膜內(nèi)皮功能失代償和正確判斷預(yù)后EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL對(duì)角膜內(nèi)皮正確評(píng)估的重要性5角膜內(nèi)皮的測(cè)量方法以往:對(duì)角膜內(nèi)皮的觀察主要是運(yùn)用細(xì)胞密度點(diǎn)記數(shù)的方法目前:角膜內(nèi)皮形態(tài)學(xué)計(jì)算機(jī)定量分析檢測(cè)EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL角膜內(nèi)皮的測(cè)量方法6高眼壓下角膜內(nèi)皮細(xì)胞的形態(tài)結(jié)構(gòu)功能到底發(fā)生了什么變化呢?EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL高眼壓下角膜內(nèi)皮細(xì)7角膜內(nèi)皮細(xì)胞的密度下降大量的國(guó)內(nèi)外文獻(xiàn)報(bào)道,對(duì)青光眼患者的觀察結(jié)果表明:角膜內(nèi)皮細(xì)胞密度均有減低高眼壓持續(xù)時(shí)間越長(zhǎng),對(duì)角膜內(nèi)皮細(xì)胞損傷越重。EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL角膜內(nèi)皮細(xì)胞的密度下降8性改變最小、最大和平均細(xì)胞面積均明顯增高細(xì)胞面積的變異系數(shù)增加六角形細(xì)胞的百分?jǐn)?shù)下降細(xì)胞多形性改變?cè)黾?有的細(xì)胞出現(xiàn)境界模糊,間隙增寬等現(xiàn)象,圓或橢圓形的細(xì)胞凋亡黑區(qū)增多且面積較大。EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL性改變9胞的影響PACG患者內(nèi)皮細(xì)胞密度下降,而且形態(tài)學(xué)也發(fā)生了明顯變化,主要表現(xiàn)為細(xì)胞大小不等,形態(tài)變異,同時(shí)周長(zhǎng)、長(zhǎng)徑等明顯增大POAG細(xì)胞密度雖有下降,但細(xì)胞大小均勻,周長(zhǎng)和長(zhǎng)徑、面積等無(wú)明顯變化EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL胞的影響10青光眼對(duì)角膜內(nèi)皮的影響課件11青光眼對(duì)角膜內(nèi)皮的影響課件12青光眼對(duì)角膜內(nèi)皮的影響課件13青光眼對(duì)角膜內(nèi)皮的影響課件14青光眼對(duì)角膜內(nèi)皮的影響課件15青光眼對(duì)角膜內(nèi)皮的影響課件16青光眼對(duì)角膜內(nèi)皮的影響課件17青光眼對(duì)角膜內(nèi)皮的影響課件18青光眼對(duì)角膜內(nèi)皮的影響課件19青光眼對(duì)角膜內(nèi)皮的影響課件20青光眼對(duì)角膜內(nèi)皮的影響課件21青光眼對(duì)角膜內(nèi)皮的影響課件22青光眼對(duì)角膜內(nèi)皮的影響課件23青光眼對(duì)角膜內(nèi)皮的影響EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL青光眼對(duì)角膜內(nèi)皮的影響24「正常角膜內(nèi)皮的形態(tài)特定的細(xì)胞鑲嵌結(jié)構(gòu)單層六邊形細(xì)胞形態(tài)和大小相當(dāng)一致EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL「正常角膜內(nèi)皮的形態(tài)25隨年齡增長(zhǎng)角膜內(nèi)皮會(huì)如何呢細(xì)胞的多型性日趨明顯細(xì)胞體積變大內(nèi)皮細(xì)胞總數(shù)和六角形細(xì)胞減少,六角形細(xì)胞仍是主要形態(tài)的細(xì)胞(>57%EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL隨年齡增長(zhǎng)角膜內(nèi)皮會(huì)如何呢26廣愈合儲(chǔ)備”(擴(kuò)展?jié)摿?維持角膜的透明的關(guān)鍵環(huán)節(jié)當(dāng)細(xì)胞隨年齡增長(zhǎng)而不斷凋亡或是受到損害時(shí),主要是通過(guò)周圍正常細(xì)胞的增大、擴(kuò)展和滑行移動(dòng)來(lái)覆蓋、填充、鋪平缺陷區(qū)域EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL廣愈合儲(chǔ)備”(擴(kuò)展?jié)摿?27對(duì)角膜內(nèi)皮正確評(píng)估的重要性當(dāng)內(nèi)皮層失去其六角形正常結(jié)構(gòu),非六角形細(xì)胞增加將使其處于不穩(wěn)定狀態(tài),導(dǎo)致屏障功能下降人類角膜內(nèi)皮細(xì)胞不能再生,由此眼科疾病或眼部手術(shù)、創(chuàng)傷均可使丟失加快防止角膜內(nèi)皮功能失代償和正確判斷預(yù)后EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL對(duì)角膜內(nèi)皮正確評(píng)估的重要性28角膜內(nèi)皮的測(cè)量方法以往:對(duì)角膜內(nèi)皮的觀察主要是運(yùn)用細(xì)胞密度點(diǎn)記數(shù)的方法目前:角膜內(nèi)皮形態(tài)學(xué)計(jì)算機(jī)定量分析檢測(cè)EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL角膜內(nèi)皮的測(cè)量方法29高眼壓下角膜內(nèi)皮細(xì)胞的形態(tài)結(jié)構(gòu)功能到底發(fā)生了什么變化呢?EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL高眼壓下角膜內(nèi)皮細(xì)30角膜內(nèi)皮細(xì)胞的密度下降大量的國(guó)內(nèi)外文獻(xiàn)報(bào)道,對(duì)青光眼患者的觀察結(jié)果表明:角膜內(nèi)皮細(xì)胞密度均有減低高眼壓持續(xù)時(shí)間越長(zhǎng),對(duì)角膜內(nèi)皮細(xì)胞損傷越重。EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL角膜內(nèi)皮細(xì)胞的密度下降31性改變最小、最大和平均細(xì)胞面積均明顯增高細(xì)胞面積的變異系數(shù)增加六角形細(xì)胞的百分?jǐn)?shù)下降細(xì)胞多形性改變?cè)黾?有的細(xì)胞出現(xiàn)境界模糊,間隙增寬等現(xiàn)象,圓或橢圓形的細(xì)胞凋亡黑區(qū)增多且面積較大。EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL性改變32胞的影響PACG患者內(nèi)皮細(xì)胞密度下降,而且形態(tài)學(xué)也發(fā)生了明顯變化,主要表現(xiàn)為細(xì)胞大小不等,形態(tài)變異,同時(shí)周長(zhǎng)、長(zhǎng)徑等明顯增大POAG細(xì)胞密度雖有下降,但細(xì)胞大小均勻,周長(zhǎng)和長(zhǎng)徑、面積等無(wú)明顯變化EvanStononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Co