角膜上皮障害の臨床的分類の提案

Clinical classification of the corneal epithelial dis-orders

　角膜上皮障害の病態を理解し適切な治療法を選択するためには，角膜上皮障害の所見の分類あるいは用語の統一が必要である。本論文では角膜上皮障害を角膜最表層細胞層あるいは翼細胞層のみが欠損したびまん性表層角膜炎，角膜上皮全層が欠損している角膜びらん，基底膜やボーマン層および角膜実質の潰瘍に伴う遷延性角膜上皮欠損の3種に分類することを提案し，その病態の差異について考察した。

To treat the various types of corneal epithelial disorders successfully with appropriate drugs, it is essential to understand the pathobiology of the epithelial disorders. For this, we propose the clini-cal classification of the corneal epithelial dis-orders; superficial punctate keratitis, corneal ero-sion and persistent corneal epithelial defects. Super-ficial punctate keratitis is the disorder where epith-elial cells of the superficial cell layer or wing cell layer are defected. In the corneal erosion, the total epithelium is defected, however, the basement membrane and Bowman's layer are kept intact. Persistent corneal epithelial defect is that of the total epithelial defects with the disorders of the basement membrane and/or Bowman's layer. The corneal stromal ulceration is often associated with the persistent corneal epithelial defect. A possible mechanism of each of these corneal epithelial dis-orders is discussed.