检测穿透性角膜移植术后巨细胞病毒角膜内皮炎的巨细胞病毒 DNA。
Detection of cytomegalovirus DNA from cytomegalovirus corneal endotheliitis after penetrating keratoplasty.
机构信息
Ideta Eye Hospital, Kumamoto City, Kumamoto, Japan.
出版信息
Cornea. 2010 Jun;29(6):683-5. doi: 10.1097/ICO.0b013e3181c325e2.
PURPOSE
To report the detection of cytomegalovirus (CMV) DNA in the cornea of a CMV endotheliitis patient after penetrating keratoplasty (PKP).
CASE
A 71-year-old man without immunodeficiency developed corneal endotheliitis in the right eye. The patient had previously received PKP several times. Polymerase chain reaction (PCR) detected CMV-DNA in the aqueous humor in his affected eye, and we started administration of ganciclovir. There was resolution of the inflammation; however, bullous keratopathy was subsequently noted in the cornea. Additional PKP was performed with perioperative intravenous administration of ganciclovir. The failed graft obtained during the additional PKP was subjected to PCR analysis and histopathological examination. PCR analysis showed CMV-DNA in the failed graft. Little inflammatory change was noted in either the epithelial or stromal layers of the failed graft. With continued ganciclovir treatment, the graft remained clear and no recurrence or rejection occurred until 12 months after the last PKP.
CONCLUSION
Our PCR analysis showed the presence of CMV-DNA within the cornea of the patient with corneal endotheliitis.
目的
报告一例穿透性角膜移植（PKP）后 CMV 性角膜内皮炎患者角膜中细胞巨化病毒（CMV）DNA 的检测情况。
病例
一名 71 岁男性，无免疫缺陷，右眼发生角膜内皮炎。该患者曾多次接受 PKP。聚合酶链反应（PCR）在受影响眼的房水中检测到 CMV-DNA，我们开始使用更昔洛韦治疗。炎症得到缓解，但随后在角膜中发现疱状角膜病变。在进行额外的 PKP 时，我们进行了围手术期静脉注射更昔洛韦。在额外的 PKP 中获得的失败移植物进行了 PCR 分析和组织病理学检查。PCR 分析显示失败移植物中有 CMV-DNA。在失败移植物的上皮或基质层中均未见明显炎症改变。继续使用更昔洛韦治疗后，移植物保持透明，在最后一次 PKP 后 12 个月内未发生复发或排斥反应。
结论
我们的 PCR 分析显示，角膜内皮炎患者的角膜中存在 CMV-DNA。
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