青光眼睫状体炎患者角膜共聚焦显微镜表现

doi:10.3760/cma.j.issn.1674-845X.2018.10.011

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摘要

目的：应用活体共聚焦显微镜（IVCM）观察青光眼睫状体炎（又称Posner-Schlossman综合征，PPS）患者角膜组织形态学改变。方法：回顾性研究。对2014 年5 月至2017 年5 月于北京大学第三医院眼科就诊的56 例PPS患者（56 眼）的病历资料进行归纳整理，记录患者的视力、眼压、裂隙灯显微镜检查结果及共聚焦显微镜下表现，包括角膜基质细胞有无活化、内皮细胞形态、有无角膜后沉着物（KP）及KP的形态、有无朗格罕氏细胞（LCs）及其形态特点。采用卡方检验进行数据分析。结果：56 例PSS患者LogMAR视力为0.3±0.2，眼压为（29.7±13.4）mmHg，使用青光眼药物的种类为（2.6±1.0）种。全部患者受累眼角膜内皮细胞呈六角形。50 例患者（89%）的患眼可以观察到角膜基质细胞活化；32 例患者（57%）的患眼可以观察到内皮面LCs；44 例患者（79%）的患眼可观察到KP，共6 种类型。以上与对侧眼相比，差异均具有统计学意义（分别为χ2=69.14，41.29，60.89，P<0.001）。结论：IVCM下可见PSS患者的角膜基质细胞活化，内皮面出现LCs及多种类型的KP。

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	洪颖
	王渺
	任靖
	肖格格
	洪晶

关键词 ：青光眼睫状体炎, 共聚焦显微镜, 角膜后沉着物, 朗格罕氏细胞

Abstract：

Objective: To investigate the in vivo confocal microscopy (IVCM) findings of corneal in Posner-Schlossman syndrome (PSS) patients. Methods: In this retrospective study, the record of 56 PSS patients (56 eyes) who visited Peking University Third Hospital Ophthalmology Department from May 2014 to May 2017 were reviewed. Data of visual acuity, intraocular pressure (IOP), keratic precipitate (KP) and IVCM results were recorded. IVCM examination included corneal stromal cell activation, corneal endothelium cell change,the morphology of KPs and the morphology of Langerhans cells (LCs). Statistical analysis was performed by a chi-square test. Results: Visual acuity of the 56 PSS patients was 0.3±0.2 (LogMAR), and IOP was 29.7±13.4 mmHg with 2.6±1.0 anti-glaucoma medications. IVCM identified 50 patients (89%) who had keratocyte activation of the affected eyes. LCs could be seen in 32 patients (57%) of the affected eyes and 6 types of KP could be observed in 44 patients (79%) of the affected eyes. There was a statistically significant difference with contralateral eyes (χ2=69.14, 41.29, 60.89, P<0.001). The corneal endothelial cells of all patients were hexagon. Conclusions: Keratocyte activation, LCs in the endothelium layer and different types of KP could be seen in PSS patients.

Key words： Posner-Schlossman syndrome in vivo confocal microscopy keratic precipitate Langerhans cells

收稿日期: 2018-03-08

通讯作者: 洪颖（ORCID：0000-0003-4000-9539），Email：hongshadow@hotmail.com

引用本文:

洪颖,王渺,任靖,肖格格,洪晶. 青光眼睫状体炎患者角膜共聚焦显微镜表现[J]. 中华眼视光学与视觉科学杂志, 2018, 20(10): 627-631. Ying Hong1, Miao Wang2, Jing Ren1, Gege Xiao1, Jing Hong1. In Vivo Confocal Microscopy of Corneal in Posner-Schlossman Syndrome. Chinese Journal of Optometry Ophthalmology and Visual science, 2018, 20(10): 627-631. DOI: 10.3760/cma.j.issn.1674-845X.2018.10.011

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[1]	Shazly TA, Aljajeh M, Latina MA. Posner-Schlossman
[1]	Shazly TA, Aljajeh M, Latina MA. Posner-Schlossman
	glaucomatocyclitic crisis. Semin Ophthalmol, 2011, 26(4-5):
28	2-284. DOI: 10.3109/08820538.2011.605821.
	glaucomatocyclitic crisis. Semin Ophthalmol, 2011, 26(4-5):
28	2-284. DOI: 10.3109/08820538.2011.605821.
[2]	Green RJ. Posner-Schlossman syndrome (glaucomatocyclitic
	crisis). Clin Exp Optom, 2007, 90(1): 53-56. DOI: 10.1111/
[2]	Green RJ. Posner-Schlossman syndrome (glaucomatocyclitic
	crisis). Clin Exp Optom, 2007, 90(1): 53-56. DOI: 10.1111/
	j.1444-0938.2006.00088.x.
	j.1444-0938.2006.00088.x.
[3]	Chee SP, Bacsal K, Jap A, et al. Clinical features of
[3]	Chee SP, Bacsal K, Jap A, et al. Clinical features of
	cytomegalovirus anterior uveitis in immunocompetent patients.
	Am J Ophthalmol, 2008, 145(5): 834-840. DOI: 10.1016/j.ajo.
	cytomegalovirus anterior uveitis in immunocompetent patients.
	Am J Ophthalmol, 2008, 145(5): 834-840. DOI: 10.1016/j.ajo.
20	07.12.015.
20	07.12.015.
[4]	Takusagawa HL, Liu Y, Wiggs JL. Infectious theories of Posner-
[4]	Takusagawa HL, Liu Y, Wiggs JL. Infectious theories of Posner-
	Schlossman syndrome. Int Ophthalmol Clin, 2011, 51(4): 105-
11	5. DOI: 10.1097/IIO.0b013e31822d6ab4.
	Schlossman syndrome. Int Ophthalmol Clin, 2011, 51(4): 105-
11	5. DOI: 10.1097/IIO.0b013e31822d6ab4.
[5]	邓世靖, 李炜炜, 侯文博, 等. 角膜内皮炎的激光共聚焦显微
	镜活体观察. 中华眼科杂志, 2012, 48(1): 9-15. DOI: 10.3760/
[5]	邓世靖, 李炜炜, 侯文博, 等. 角膜内皮炎的激光共聚焦显微
	镜活体观察. 中华眼科杂志, 2012, 48(1): 9-15. DOI: 10.3760/
	cma.j.issn.0412-4081.2012.01.004.
	cma.j.issn.0412-4081.2012.01.004.
[6]	Hamrah P, Cruzat A, Dastjerdi MH, et al. Corneal sensation
[6]	Hamrah P, Cruzat A, Dastjerdi MH, et al. Corneal sensation
	and subbasal nerve alterations in patients with herpes simplex
	and subbasal nerve alterations in patients with herpes simplex
	keratitis: an in vivo confocal microscopy study. Ophthalmology,
20	10, 117(10): 1930-1936. DOI: 10.1016/j.ophtha.2010.07.010.
	keratitis: an in vivo confocal microscopy study. Ophthalmology,
20	10, 117(10): 1930-1936. DOI: 10.1016/j.ophtha.2010.07.010.
[7]	Alomar TS, Nubile M, Lowe J, et al. Corneal intraepithelial
[7]	Alomar TS, Nubile M, Lowe J, et al. Corneal intraepithelial
	neoplasia: in vivo confocal microscopic study with
	neoplasia: in vivo confocal microscopic study with
	histopathologic correlation. Am J Ophthalmol, 2011, 151(2):
23	8-247. DOI: 10.1016/j.ajo.2010.08.035.
	histopathologic correlation. Am J Ophthalmol, 2011, 151(2):
23	8-247. DOI: 10.1016/j.ajo.2010.08.035.
[8]	Hamrah P, Sahin A, Dastjerdi MH, et al. Cellular changes of the
[8]	Hamrah P, Sahin A, Dastjerdi MH, et al. Cellular changes of the
	corneal epithelium and stroma in herpes simplex keratitis: an in
	corneal epithelium and stroma in herpes simplex keratitis: an in
	vivo confocal microscopy study. Ophthalmology, 2012, 119(9):
17	91-1797. DOI: 10.1016/j.ophtha.2012.03.005.
	vivo confocal microscopy study. Ophthalmology, 2012, 119(9):
17	91-1797. DOI: 10.1016/j.ophtha.2012.03.005.
[9]	Mocan MC, Kadayifcilar S, Irkec M. Keratic precipitate
[9]	Mocan MC, Kadayifcilar S, Irkec M. Keratic precipitate
	morphology in uveitic syndromes including Behçet's disease as
	morphology in uveitic syndromes including Behçet's disease as
	evaluated with in vivo confocal microscopy. Eye (Lond), 2009,
23	(5): 1221-1227. DOI: 10.1038/eye.2008.239.
	evaluated with in vivo confocal microscopy. Eye (Lond), 2009,
23	(5): 1221-1227. DOI: 10.1038/eye.2008.239.
[10]	Mocan MC, Kadayifcilar S, Irkeç M. In vivo confocal
[10]	Mocan MC, Kadayifcilar S, Irkeç M. In vivo confocal
	microscopic evaluation of keratic precipitates and endothelial
	microscopic evaluation of keratic precipitates and endothelial
	morphology in Fuchs' uveitis syndrome. Eye (Lond), 2012,
26	(1): 119-125. DOI: 10.1038/eye.2011.268.
	morphology in Fuchs' uveitis syndrome. Eye (Lond), 2012,
26	(1): 119-125. DOI: 10.1038/eye.2011.268.
[11]	Kanavi MR, Soheilian M. Confocal scan features of keratic
[11]	Kanavi MR, Soheilian M. Confocal scan features of keratic
	precipitates in granulomatous versus nongranulomatous uveitis.
	precipitates in granulomatous versus nongranulomatous uveitis.
	J Ophthalmic Vis Res, 2011, 6(4): 255-258.
	J Ophthalmic Vis Res, 2011, 6(4): 255-258.
[12]	张莎莎, 桂四凤, 钱倩, 等. 神经生长因子滴眼液对兔眼
	LASIK术后角膜神经修复的影响. 中华眼视光学与视觉科学
[12]	张莎莎, 桂四凤, 钱倩, 等. 神经生长因子滴眼液对兔眼
	杂志, 2017, 19(1): 33-39. DOI: 10.3760/cma.j.issn.1674-845X.
	LASIK术后角膜神经修复的影响. 中华眼视光学与视觉科学
	杂志, 2017, 19(1): 33-39. DOI: 10.3760/cma.j.issn.1674-845X.
20	17.01.007.
20	17.01.007.
[13]	张亚丽, 刘丽梅, 刘玉强, 等. 离子导入角膜胶原交联法治疗
	兔棘阿米巴性角膜炎. 中华眼视光学与视觉科学杂志, 2017,
[13]	张亚丽, 刘丽梅, 刘玉强, 等. 离子导入角膜胶原交联法治疗
19	(9): 533-539. DOI: 10.3760/cma.j.issn.1674-845X.2017.09.
	兔棘阿米巴性角膜炎. 中华眼视光学与视觉科学杂志, 2017,
	004.
19	(9): 533-539. DOI: 10.3760/cma.j.issn.1674-845X.2017.09.
[14]	Li J, Ang M, Cheung CM, et al. Aqueous cytokine changes
	004.
	associated with Posner-Schlossman syndrome with and without
	human cytomegalovirus. PLoS One, 2012, 7(9): e44453. DOI:
[14]	Li J, Ang M, Cheung CM, et al. Aqueous cytokine changes
10	1371/journal.pone.0044453.
	associated with Posner-Schlossman syndrome with and without
	human cytomegalovirus. PLoS One, 2012, 7(9): e44453. DOI:
[15]	Mustonen RK, McDonald MB, Srivannaboon S, et al. Normal
10	1371/journal.pone.0044453.
[15]	Mustonen RK, McDonald MB, Srivannaboon S, et al. Normal
	human corneal cell populations evaluated by in vivo scanning
	human corneal cell populations evaluated by in vivo scanning
	slit confocal microscopy. Cornea, 1998, 17(5): 485-492.
	slit confocal microscopy. Cornea, 1998, 17(5): 485-492.
[16]	Ohno K, Mitooka K, Nelson LR, et al. Keratocyte activation and
	apoptosis in transplanted human corneas in a xenograft model.
[16]	Ohno K, Mitooka K, Nelson LR, et al. Keratocyte activation and
	apoptosis in transplanted human corneas in a xenograft model.
	Invest Ophthalmol Vis Sci, 2002, 43(4): 1025-1031.
	Invest Ophthalmol Vis Sci, 2002, 43(4): 1025-1031.
[17]	Marsovszky L, Resch MD, Németh J, et al. In vivo confocal
	microscopic evaluation of corneal Langerhans cell density, and
[17]	Marsovszky L, Resch MD, Németh J, et al. In vivo confocal
	distribution and evaluation of dry eye in rheumatoid arthritis. Innate
	microscopic evaluation of corneal Langerhans cell density, and
	Immun, 2013, 19(4): 348-354. DOI: 10.1177/1753425912461677.
	distribution and evaluation of dry eye in rheumatoid arthritis. Innate
[18]	Zhivov A, Stave J, Vollmar B, et al. In vivo confocal microscopic
	Immun, 2013, 19(4): 348-354. DOI: 10.1177/1753425912461677.
	evaluation of langerhans cell density and distribution in the corneal
[18]	Zhivov A, Stave J, Vollmar B, et al. In vivo confocal microscopic
	epithelium of healthy volunteers and contact lens wearers. Cornea,
20	07, 26(1): 47-54. DOI: 10.1097/ICO.0b013e31802e3b55.
	evaluation of langerhans cell density and distribution in the corneal
[19]	Zhivov A, Stave J, Vollmar B, et al. In vivo confocal microscopic
	epithelium of healthy volunteers and contact lens wearers. Cornea,
20	07, 26(1): 47-54. DOI: 10.1097/ICO.0b013e31802e3b55.
	evaluation of Langerhans cell density and distribution in the normal
[19]	Zhivov A, Stave J, Vollmar B, et al. In vivo confocal microscopic
	human corneal epithelium. Graefes Arch Clin Exp Ophthalmol,
20	05, 243(10): 1056-1061. DOI: 10.1007/s00417-004-1075-8.
	evaluation of Langerhans cell density and distribution in the normal
[20]	Huang W, Chen S, Gao X, et al. Inflammation-related cytokines
	human corneal epithelium. Graefes Arch Clin Exp Ophthalmol,
20	05, 243(10): 1056-1061. DOI: 10.1007/s00417-004-1075-8.
	of aqueous humor in acute primary angle-closure eyes. Invest
	Ophthalmol Vis Sci, 2014, 55(2): 1088-1094. DOI: 10.1167/
[20]	Huang W, Chen S, Gao X, et al. Inflammation-related cytokines
	iovs.13-13591.
	of aqueous humor in acute primary angle-closure eyes. Invest
	Ophthalmol Vis Sci, 2014, 55(2): 1088-1094. DOI: 10.1167/
[21]	Freedman J, Iserovich P. Pro-inflammatory cytokines in
	iovs.13-13591.
	glaucomatous aqueous and encysted Molteno implant blebs and
[21]	Freedman J, Iserovich P. Pro-inflammatory cytokines in
	their relationship to pressure. Invest Ophthalmol Vis Sci, 2013,
54	(7): 4851-4855. DOI: 10.1167/iovs.13-12274.
	glaucomatous aqueous and encysted Molteno implant blebs and
[22]	Takahashi T, Ohtani S, Miyata K, et al. A clinical evaluation of
	their relationship to pressure. Invest Ophthalmol Vis Sci, 2013,
54	(7): 4851-4855. DOI: 10.1167/iovs.13-12274.
	uveitis-associated secondary glaucoma. Jpn J Ophthalmol, 2002,
[22]	Takahashi T, Ohtani S, Miyata K, et al. A clinical evaluation of
46	(5): 556-562.
	uveitis-associated secondary glaucoma. Jpn J Ophthalmol, 2002,
46	(5): 556-562.
[23]	Shen SC, Ho WJ, Wu SC, et al. Peripheral vascular endothelial
[23]	Shen SC, Ho WJ, Wu SC, et al. Peripheral vascular endothelial
	dysfunction in glaucomatocyclitic crisis: a preliminary study.
	Invest Ophthalmol Vis Sci, 2010, 51(1): 272-276. DOI: 10.1167/
	dysfunction in glaucomatocyclitic crisis: a preliminary study.
	Invest Ophthalmol Vis Sci, 2010, 51(1): 272-276. DOI: 10.1167/
	iovs.09-3849.
	iovs.09-3849.
[24]	Pillai CT, Dua HS, Azuara-Blanco A. Evaluation of corneal
[24]	Pillai CT, Dua HS, Azuara-Blanco A. Evaluation of corneal
	endothelium and keratic precipitates by specular microscopy in
	endothelium and keratic precipitates by specular microscopy in
	anterior uveitis. Br J Ophthalmol, 2000, 84(12): 1367-1371.
	anterior uveitis. Br J Ophthalmol, 2000, 84(12): 1367-1371.