Diesenhouse M C, Palay D A, Newman N J, To K, Albert D M
Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA.
Ophthalmology. 1992 Dec;99(12):1815-7. doi: 10.1016/s0161-6420(92)31720-8.
Heterochromia iridis, asymmetry of iris pigmentation, has been well described with congenital Horner syndrome. Acquired heterochromia associated with lesions in the ocular sympathetic pathways in adulthood, however, is rare.
Two cases are reported in which sympathectomy in adults resulted in ipsilateral Horner syndrome with heterochromia. In each case, pharmacologic testing with cocaine and hydroxyamphetamine was performed.
In both cases, sympathectomy occurred at the level of the second order neuron, but hydroxyamphetamine testing suggested at least partial third order neuron involvement.
Acquired heterochromia can occur in adults. The partial response to hydroxyamphetamine in the two cases presented may reflect trans-synaptic degeneration of the postganglionic neuron. A reduction in trophic influences on iris melanocytes may have contributed to the observed heterochromia.
虹膜异色症，即虹膜色素沉着不对称，在先天性霍纳综合征中已有详细描述。然而，成年后与眼交感神经通路病变相关的后天性虹膜异色症却很罕见。
报告了两例成人交感神经切除术导致同侧霍纳综合征伴虹膜异色症的病例。在每个病例中，均进行了可卡因和羟苯丙胺的药理测试。
两例病例中，交感神经切除术均发生在二级神经元水平，但羟苯丙胺测试提示至少部分三级神经元受累。
后天性虹膜异色症可发生于成年人。所呈现的两例病例对羟苯丙胺的部分反应可能反映了节后神经元的跨突触变性。对虹膜黑素细胞营养影响的降低可能导致了观察到的虹膜异色症。
