Wirostko E, Johnson L, Wirostko B
Edward S Harkness Eye Institute, New York, NY 10032.
Br J Ophthalmol. 1991 Nov;75(11):671-4. doi: 10.1136/bjo.75.11.671.
Cataracts often occur in humans secondary to uveitis. Uveitis may be caused by various infectious agents, but rarely is the agent detected in the cataract. Mycoplasma-like organisms (MLO) were recently reported to cause human uveitis and retinitis. Cataracts were often present in those inflamed eyes. MLO are intracellular cell wall deficient pathogenic bacteria. They are pleomorphic tubulospherical and filamentous organisms with a characteristic ultrastructural appearance. No MLO culture system has been found despite 20 years of effort. The diagnosis of MLO disease rests on detection of the organisms in parasitised cells by a transmission electron microscope and response to antibiotics. In human intraocular inflammatory disease MLO are detectable in parasitised leucocytes and retinal pigment epithelial cells at the disease sites. Inoculation of MLO from a human source into mouse eyelids produced intraocular, chronic, progressive, inflammatory disease, with intraocular leucocytes parasitised by MLO in 15 of 100 mice versus 0 in 200 controls (p less than 0.05). This report describes the cataracts with MLO-parasitised intralenticular leucocytes in the inflamed eyes of 14 of those 15 mice versus 0 in 200 control mice (p less than 0.05). The results indicate that MLO penetrated the lens capsules to produce the cataracts, and they suggest that MLO could cause human cataracts. Alternative methods for detection of MLO and rifampin treatment of MLO intraocular disease are discussed.
白内障在人类中常继发于葡萄膜炎。葡萄膜炎可能由多种感染因子引起,但在白内障中很少能检测到病原体。最近有报道称类支原体生物(MLO)可导致人类葡萄膜炎和视网膜炎。在那些发炎的眼睛中常常存在白内障。MLO是细胞内缺乏细胞壁的致病细菌。它们是多形性的管状球形和丝状生物,具有特征性的超微结构外观。尽管经过20年的努力,尚未找到MLO培养系统。MLO疾病的诊断依赖于通过透射电子显微镜在被寄生细胞中检测到这些生物以及对抗生素的反应。在人类眼内炎性疾病中,在疾病部位的被寄生白细胞和视网膜色素上皮细胞中可检测到MLO。将源自人类的MLO接种到小鼠眼睑中可产生眼内慢性进行性炎性疾病,在100只小鼠中有15只小鼠的眼内白细胞被MLO寄生,而200只对照小鼠中为0只(p小于0.05)。本报告描述了在这15只小鼠中有14只发炎眼睛的晶状体中有被MLO寄生的晶状体白细胞的白内障情况,而200只对照小鼠中为0只(p小于0.05)。结果表明MLO穿透晶状体囊膜导致白内障,提示MLO可能导致人类白内障。还讨论了检测MLO的替代方法以及利福平治疗MLO眼内疾病的情况。