Yamada Masakazu, Nishiyama Takatsune, Konishi Minako, Mashima Yukihiko
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Jpn J Ophthalmol. 2002 May-Jun;46(3):305-7. doi: 10.1016/s0021-5155(02)00483-5.
To describe a case of secondary amyloidosis that occurred in a corneal graft.
A 30-year-old Japanese woman had opacities in the corneal graft in her right eye. Slit-lamp microscopy examination demonstrated nodular, subepithelial opacities in the graft. Results of a physical examination and her past medical history were unremarkable, except for a history of a penetrating keratoplasty for keratoconus at the age of 17. Since then, the patient had worn a hard contact lens for over 10 years. The specimen obtained by keratectomy was examined histologically.
The histologic examination revealed hyaline, and amorphous materials stained with Congo red, which were dichroic under polarized light. Transmission electron microscopy showed the characteristic fibrillar pattern of amyloid.
This appears to be the first reported case of secondary amyloidosis in a corneal graft. A long-standing history of hard contact lens wear may play a role in the pathogenesis of this rare condition.
描述一例发生于角膜移植的继发性淀粉样变性病例。
一名30岁的日本女性右眼角膜移植片出现混浊。裂隙灯显微镜检查显示移植片中存在结节状、上皮下混浊。体格检查及既往病史无明显异常，仅17岁时因圆锥角膜行穿透性角膜移植术。此后，该患者佩戴硬性角膜接触镜超过10年。对角膜切除术获取的标本进行组织学检查。
组织学检查显示透明样、无定形物质，刚果红染色阳性，在偏振光下呈双色性。透射电子显微镜显示淀粉样蛋白特有的纤维状结构。
这似乎是首例报道的角膜移植继发性淀粉样变性病例。长期佩戴硬性角膜接触镜可能在这种罕见疾病的发病机制中起作用。
