用麻醉测量法评估角膜神经:历史、进展和未来方向

Vision Pub Date : 2024-05-12 DOI:10.3390/vision8020034
Jordan R. Crabtree, Shadia Tannir, Khoa Tran, C. Boente, Asim Ali, Gregory H. Borschel
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引用次数: 0

摘要

角膜感觉的测量可让临床医生评估角膜神经支配的状态,是角膜疾病和眼睛健康的重要指标。目前有许多设备可用于评估角膜感觉,包括 Cochet-Bonnet 角膜感觉仪、Belmonte 角膜感觉仪、瑞士液体喷射角膜感觉仪和新推出的 Brill 角膜感觉仪。随着体内共焦显微镜和光学相干断层扫描技术在临床上的应用日益广泛,人们将能更深入地了解神经营养性角膜病等眼表疾病的诊断、分类和监测情况;然而,正式的角膜曲率计测量仍然是评估角膜神经功能状态所必需的。这些动眼神经刺激仪在角膜刺激的产生模式、相对的可及性、精确性和临床使用的简便性方面存在很大差异。未来对这些特性进行优化的设备的开发,以及设备类型之间的进一步比较研究,应能更准确、更精确地诊断和治疗角膜神经支配缺陷。这篇叙述性综述的目的是描述自美学计应用于临床实践以来所取得的进步,比较目前可用的角膜神经支配评估设备及其相对局限性,并讨论角膜神经支配评估对于了解和治疗眼表病变的重要性。
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Corneal Nerve Assessment by Aesthesiometry: History, Advancements, and Future Directions
The measurement of corneal sensation allows clinicians to assess the status of corneal innervation and serves as a crucial indicator of corneal disease and eye health. Many devices are available to assess corneal sensation, including the Cochet–Bonnet aesthesiometer, the Belmonte Aesthesiometer, the Swiss Liquid Jet Aesthesiometer, and the newly introduced Corneal Esthesiometer Brill. Increasing the clinical use of in vivo confocal microscopy and optical coherence tomography will allow for greater insight into the diagnosis, classification, and monitoring of ocular surface diseases such as neurotrophic keratopathy; however, formal esthesiometric measurement remains necessary to assess the functional status of corneal nerves. These aesthesiometers vary widely in their mode of corneal stimulus generation and their relative accessibility, precision, and ease of clinical use. The development of future devices to optimize these characteristics, as well as further comparative studies between device types should enable more accurate and precise diagnosis and treatment of corneal innervation deficits. The purpose of this narrative review is to describe the advancements in the use of aesthesiometers since their introduction to clinical practice, compare currently available devices for assessing corneal innervation and their relative limitations, and discuss how the assessment of corneal innervation is crucial to understanding and treating pathologies of the ocular surface.
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