Objective:To analyze the morphologic features of corneal superficial epithelial cells and ker‐atocytes by in vivo confocal microscopy in patients with herpes simplex keratitis (HSK) as associated with corneal innervation .Methods :We continued collecting 50 cases (100 eyes) with non acute period HSK who treated in our hospital and 50 healthy cases (100 eyes) at same time .Changes in morphologic features and density of the superficial epithelial cells ,were assessed by 2 masked observers .Changes were correlated to corneal sensation .Results:There was a significant decrease in the density of superficial epithelial cells 1287 .78 ± 102 .54 cells/mm2 in HSK eyes , 2425 .18 ± 202 .13 cells/mm2 in contralateral eyes and 2435 .23 ± 224 .3 cells/mm2 in normal eyes (P<0 .05) .Super‐ficial epithelial cell size was 2 .5‐fold larger in HSK eyes (606 .62 ± 198 .23 mm2 ) compared with contralateral (415 . 36 ± 58 .13 mm2 ) or normal eyes (409 .21 ± 63 .20mm2 ;P<0 .05) .Changes in superficial epithelial cell density(r=‐0 .90)and morphologic features (r = 0 .81)correlated strongly with corneal sensation(P<0 .05) .Conclusion:In vivo confocal microscopy reveals profound HSK‐induced changes in the superficial epithelium ,as demonstrated by increase in cell size ,decrease in cell density ,and squamous metaplasia .This study demonstrated that these changes correlate strongly with changes in corneal innervation .%目的：通过活体共聚焦显微镜观察单纯疱疹病毒性角膜炎（HSK）患者角膜表层上皮细胞变化及其与角膜神经知觉关系的相关性。方法：诊断单眼HSK的非急性期复查患者50例（100只眼），和50例未患过HSK健康体检者（100只眼）。行角膜知觉、活体共聚焦显微镜检查并对共焦显微镜图像进行分析、记录。结果：HSK患者患眼角膜表层上皮细胞数为1287．78±102．54cells／mm2，其密度显著低于对侧眼角膜表层上皮细胞数的2425．18±202．13cells／mm2和健康对照者角膜表层上皮细胞数2435．23±224．3cells／mm2（P＜0．05）。HSK患者患眼角膜表层上皮细胞面积为606．62±198．23mm2，较对侧眼角膜表层上皮细胞面积415．36±58．13mm2和健康对照者角膜表层上皮细胞面积409．21±63．20mm2，显著增大，差异有统计学意义（P＜0．05）。HSK患者患眼角膜知觉正常8例（8只眼），角膜知觉轻度异常34例（34只眼），角膜知觉重度异常8例（8只眼），角膜知觉度与HSK患者的角膜表层上皮细胞密度呈负相关（r＝－0．90，P＜0．05），与HSK患者的角膜表层上皮细胞面积呈正相关（r＝0．81，P＜0．05）。结论：HSK导致角膜表层上皮细胞密度降低，通过细胞体积增大来代偿，这些改变与角膜神经功能改变密切相关。
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