Schlötzer-Schrehardt U, Holbach L M, Hofmann-Rummelt C, Naumann G O
Department Of Ophthalmology, University Nürnberg, Erlangen, Germany.
Cornea. 2001 Jul;20(5):553-7. doi: 10.1097/00003226-200107000-00026.
To document the clinical and histopathologic corneal features of a patient who developed multifocal corneal argyrosis after a chemical explosion injury with unusual involvement of the corneal stroma and keratocytes.
The corneal button was investigated by light and transmission electron microscopy and scanning electron microscopy combined with energy-dispersive x-ray microanalysis.
Clinically, the patient showed dark discoloration of the lids, periocular skin, episclera, and conjunctiva and had multiple brown dots in the superficial layers of the cornea. Microscopic examination of the cornea showed diffuse deposition of silver particles in the epithelial basement membrane, Bowman's layer, and Descemet's membrane. In the corneal stroma, silver granules accumulated intracellularly within lysosomal structures of degenerative keratocytes and extracellularly in association with collagen fibers and cellular debris. Energy-dispersive x-ray analysis showed peaks of silver and sulfur.
The toxic influence of intracellular accumulation of silver in stromal keratocytes may lead to cell damage and necrosis and result in visual impairment.
记录一名在化学爆炸伤后发生多灶性角膜银沉着症的患者的临床和组织病理学角膜特征，该患者角膜基质和角膜细胞受累情况异常。
对角膜组织块进行光镜、透射电子显微镜检查以及扫描电子显微镜结合能量色散X射线微分析。
临床上，患者眼睑、眼周皮肤、巩膜表层和结膜出现色素沉着，角膜表层有多个棕色斑点。角膜显微镜检查显示银颗粒弥漫沉积于上皮基底膜、Bowman层和Descemet膜。在角膜基质中，银颗粒在变性角膜细胞的溶酶体结构内细胞内积聚，并在细胞外与胶原纤维和细胞碎片相关联。能量色散X射线分析显示银和硫的峰值。
基质角膜细胞内银积聚的毒性影响可能导致细胞损伤和坏死，并导致视力损害。
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