共聚焦显微镜在一名疑似巨细胞病毒性角膜内皮炎患者中显示出“猫头鹰眼”形态。
Demonstration of "owl's eye" morphology by confocal microscopy in a patient with presumed cytomegalovirus corneal endotheliitis.
作者信息
Shiraishi Atsushi, Hara Yuko, Takahashi Miyabi, Oka Naoko, Yamaguchi Masahiko, Suzuki Takashi, Uno Toshihiko, Ohashi Yuichi
机构信息
Department of Ophthalmology, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan.
出版信息
Am J Ophthalmol. 2007 Apr;143(4):715-7. doi: 10.1016/j.ajo.2006.11.026. Epub 2006 Dec 19.
PURPOSE
To report confocal microscopic observations of characteristic corneal endothelial lesions in a patient with presumed cytomegalovirus (CMV) corneal endotheliitis.
DESIGN
Case report.
METHODS
A 77-year-old, immunocompetent man was admitted with corneal edema, keratic precipitates, and coin-shaped lesions in the right eye. Confocal microscopy was performed to examine the corneal endothelium. Polymerase chain reaction (PCR) was used to identify viral DNA in an aqueous humor sample.
RESULTS
CMV DNA was detected by PCR. Confocal microscopy showed large corneal endothelial cells with an area of high reflection in the nucleus surrounded by a halo of low reflection. This "owl's eye" morphology is characteristic of CMV infection. Topical and intravenous ganciclovir treatment resulted in rapid resolution of the corneal precipitates and edema, followed by disappearance of the owl's eye morphology.
CONCLUSIONS
Confocal microscopy can detect the owl's eye morphology in the corneal endothelium of patients with presumed CMV corneal endotheliitis.
目的
报告对一名疑似巨细胞病毒（CMV）角膜内皮炎患者角膜内皮特征性病变的共焦显微镜观察结果。
设计
病例报告。
方法
一名77岁免疫功能正常的男性因右眼角膜水肿、角膜后沉着物及钱币状病变入院。进行共焦显微镜检查以观察角膜内皮。采用聚合酶链反应（PCR）检测房水样本中的病毒DNA。
结果
通过PCR检测到CMV DNA。共焦显微镜显示角膜内皮细胞较大，细胞核内有高反射区域，周围有低反射晕。这种“猫头鹰眼”形态是CMV感染的特征。局部和静脉注射更昔洛韦治疗后，角膜沉着物和水肿迅速消退，随后“猫头鹰眼”形态消失。
结论
共焦显微镜可检测疑似CMV角膜内皮炎患者角膜内皮的“猫头鹰眼”形态。
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