Knappe S, Stave J, Guthoff R F
Augenklinik, Universität, Rostock.
Ophthalmologe. 2005 Aug;102(8):798-801. doi: 10.1007/s00347-004-1046-9.
Epidemic keratoconjunctivitis (EKC) is a highly contagious infection caused by adenovirus types 8, 19, and 37. The formation of subepithelial nummular infiltrates may lead to permanent visual disturbance. These infiltrates consist histopathologically of an accumulation of lymphocytes, histiocytes, and fibroblasts.
The reasons for the persistence of these nummular infiltrates are not fully understood. We examined a 28-year-old female patient with typical signs of EKC infection clinically and additionally with the RLSM.
Nummuli were identified by the RLSM as areas with an accumulation of dendritic cells (supposed to be Langerhans cells) as well as so far unidentified punctiform structures located in the basal cell layer and in the region of the subepithelial nerve plexus.
The RLSM allows us to investigate corneal microstructures in vivo with precise depth localization related to epidemic keratoconjunctivitis. Further investigations may disclose the role of dendritic cells in the pathogenesis of the nummular formation as well as their contribution to the variable persistence of partially threatening vision opacities.
流行性角结膜炎（EKC）是由8型、19型和37型腺病毒引起的一种高度传染性感染。上皮下钱币状浸润的形成可能导致永久性视力障碍。这些浸润在组织病理学上由淋巴细胞、组织细胞和成纤维细胞的积聚组成。
这些钱币状浸润持续存在的原因尚未完全明确。我们对一名28岁患有典型EKC感染体征的女性患者进行了临床检查，并额外采用了共振增强显微镜（RLSM）进行检查。
通过RLSM识别出钱币状区域为树突状细胞（推测为朗格汉斯细胞）以及位于基底细胞层和上皮下神经丛区域的迄今未明确的点状结构积聚的区域。
RLSM使我们能够在体内研究与流行性角结膜炎相关的具有精确深度定位的角膜微观结构。进一步的研究可能会揭示树突状细胞在钱币状形成的发病机制中的作用，以及它们对部分威胁视力的混浊物持续时间变化的影响。
