Observation Of Corneal Endothelium In Juvenile And Children Uveitis

Objective To observe morphological changes and abnormal structures of corneal endothelium in juvenile and children uveitis, and to analyze the factors affecting the morphological changes of corneal endothelium, so as to investigate the clinical application of specular microscopy in juvenile and children uveitis.Methods 70 patients (140 eyes) with juvenile and children uveitis were collected. Took pictures of corneal endothelium with Topcon SP-3000 non-contact specular microscopy, and determined the corneal endothelium cell density (CD), average cell area (AVE), coefficient of variation of average area (CV), and percentage of hexagonal cells (6A) with IMAGEnet system. Directly observe morphological changes and special abnormal structure of the corneal endothelium by comparing the affected eyes with the healthy ones. Then selected 28 patients (56 eyes) with unilateral juvenile and children uveitis, setting the affected eyes (28 eyes) as the experimental group while the healthy eyes (28 eyes) as the self-control group, and analyzed the corneal endothelium parameters of the two groups by statistics. After that,selected all the affected eyes (112 eyes) of 70 patients with juvenile and children uveitis to make contrastive analysis of the gender, laterality-related differences of the corneal endothelium parameters. Simultaneously, make analysis of the influence of course of disease, inflammatory cells in the anterior chamber and keratic precipitates (KP) on the corneal endothelium parameters. All the data were analyzed by Statistical Package for the Social Sciences (SPSS).Results There were four kinds of abnormal morphology of corneal endothelium in the affected eyes with juvenile and children uveitis: increasing differences of cell size, irregularity of cell shape, blur of cell gap and cell loss. KP revealed irregular and highly reflective white spots, which is surrounded by dark spaces, and existed in the affected eyes found dust KP as well as a small number of the ones with no obvious KP in the slit-lamp examination. Comparing the corneal endothelium parameters between the experimental group and the self-control group, CD and 6A of the former were statistically significantly lower than that of the latter (t=-3.966, -2.516; P=0.000, 0.018); AVE and CV of the former were statistically significantly higher than that of the latter (t=2.657, 2.097; P=0.013, 0.046). There was no statistically significant differences of corneal endothelium parameters between patients of different gender or affected eyes of different lateral (P>0.05). In the analysis of influencing factors of corneal endothelium parameters, CD of the affected eyes over 1 year were statistically significantly lower than that of the ones not over 1 year (F=8.987; P=0.003); and CV of the affected eyes with KP were statistically significantly higher than that of the ones without KP (F=4.842; P=0.030). In addition, the influence of the interaction of the three factors (course of disease, inflammatory cells in the anterior chamber and KP) on CD was statistically significant (F=6.224; P=0.014). And the others main effects or interactions of these factors on the others parameters showed no statistically significance (P>0.05).Conclusions 1. By the examination of specular microscopy, abnormal morphology and structures of corneal endothelium can be observed in juvenile and children uveitis eyes, and some fine KP that slit-lamp examination missed can be found.2. The influence of uveitis on corneal endothelium parameters of juvenile and children uveitis eyes was statistically significant.3. The influence of course of uveitis on CD, the influence of KP on CV, and the influence of the interaction of the three factors (course of disease, inflammatory cells in the anterior chamber and KP) on CD were statistically significant in juvenile and children uveitis eyes.4. The qualitative and quantitative analysis of corneal endothelium by the examination of specular microscopy with IMAGEnet system was significant in clinical application of diagnosis, prognosis and preoperative evaluation of complications of juvenile and children uveitis.