Brandt F, Zhou H M, Shi Z R, Rai N, Thuladar L, Pradhan H
Department of Pathology, Nepal Eye Hospital, Kathmandu.
Br J Ophthalmol. 1990 Jan;74(1):14-8. doi: 10.1136/bjo.74.1.14.
From 43 Nepalese leprosy patients skin smear negative, and treated with dapsone (diamino diphenyl sulphone), and without any sign of active leprosy or iritis, specimens from iridectomy during cataract surgery were studied histopathologically. Of 49 iris specimens only six (12%) were found to be without any histopathological change. Atrophy of the iris stroma was seen in 63% and neovascularisation in 6% of all cases. In 16% in which the dilator muscle could be detected, it was atrophic, and in 11% the pigmented epithelium was thinned and atrophic. Cellular inflammatory infiltrations were seen in 88% of all specimens. They were mostly slight in eyes which before operation had been without posterior synechiae of the iris. In most of the eyes in which posterior synechiae had been present moderate or heavy inflammatory cell infiltrates composed of lymphocytes and plasma cells, often associated with macrophages, neutrophils, or eosinophils, were found. In five iris specimens acid fast bacilli were present. This raises the question whether these can survive systemically despite dapsone chemotherapy in the iris, thus leading to dapsone-resistant leprosy and to recurrent iritis.
对43例尼泊尔麻风病患者进行研究，这些患者皮肤涂片阴性，接受氨苯砜（二氨二苯砜）治疗，且无任何活动性麻风病或虹膜炎迹象，对其白内障手术期间虹膜切除术的标本进行了组织病理学研究。在49个虹膜标本中，仅6个（12%）未发现任何组织病理学改变。在所有病例中，63%可见虹膜基质萎缩，6%可见新生血管形成。在16%可检测到瞳孔开大肌的病例中，该肌肉萎缩，11%的色素上皮变薄且萎缩。在所有标本的88%中可见细胞性炎性浸润。在术前无虹膜后粘连的眼中，炎性浸润大多较轻。在大多数存在虹膜后粘连的眼中，发现了由淋巴细胞和浆细胞组成的中度或重度炎性细胞浸润，常伴有巨噬细胞、中性粒细胞或嗜酸性粒细胞。在5个虹膜标本中发现了抗酸杆菌。这就提出了一个问题，即尽管在虹膜中进行了氨苯砜化疗，这些抗酸杆菌是否仍能在全身存活，从而导致耐氨苯砜麻风病和复发性虹膜炎。
