Morris Robert W, Dunbar Mark T
Eyecare Associates, Woodruff, Wisconsin, USA.
Optometry. 2004 Jan;75(1):13-25. doi: 10.1016/s1529-1839(04)70007-x.
The different variants of the iridocorneal endothelial (ICE) syndrome were separately described in the early to mid-1900's and were eventually linked to a common etiology of an abnormal corneal endothelium. The ICE syndrome typically manifests in early to middle adulthood, usually occurs in women, and is almost always unilateral. Management of patients with any variant of the ICE syndrome challenges even the best clinicians.
We present a 52-year-old patient with Chandler's syndrome. Our patient shared many of the classic characteristics of Chandler's syndrome, including peripheral anterior synechiae and corneal edema, with one unusual aspect--the patient was male. Details regarding the subsets of the ICE syndrome, differential diagnosis, and current understanding of the pathophysiology are also reviewed.
The ICE syndrome is a progressive anterior segment disease that is quite difficult to manage. Corneal edema, increased IOP, and glaucoma are all sequelae of these conditions and, even in the best hands, are extremely challenging to manage. Today, nearly 100 years after Harms described the first patient with an ICE syndrome, we still do not know the exact mechanism for the corneal endothelial changes. Many investigations have been made into the causative agent or stimulus for abnormal endothelial growth in the ICE syndrome. No definitive proof has been established, but a relationship may exist with the Herpes Simplex and Epstein-Barr viruses. Further investigation is needed to determine the most-appropriate treatment and management of the ICE syndrome.
虹膜角膜内皮（ICE）综合征的不同变体在20世纪初至中叶被分别描述，最终被认为与角膜内皮异常这一共同病因有关。ICE综合征通常在成年早期至中期出现，多见于女性，且几乎总是单侧发病。对ICE综合征任何变体患者的治疗，即便对最优秀的临床医生来说也是一项挑战。
我们介绍一位患有钱德勒综合征的52岁患者。该患者具有许多钱德勒综合征的典型特征，包括周边前粘连和角膜水肿，但有一个不同寻常之处——患者为男性。本文还回顾了ICE综合征各亚型、鉴别诊断以及目前对病理生理学的认识等细节。
ICE综合征是一种进行性眼前节疾病，治疗难度很大。角膜水肿、眼压升高和青光眼都是这些病症的后遗症，即使由最出色的医生治疗，也极具挑战性。如今，在哈姆斯描述首例ICE综合征患者近100年后，我们仍不清楚角膜内皮变化的确切机制。针对ICE综合征中异常内皮生长的病原体或刺激因素已开展了许多研究。虽未确立明确证据，但可能与单纯疱疹病毒和EB病毒有关。需要进一步研究以确定ICE综合征最合适的治疗和管理方法。
