Sheybani Arsham, Harocopos George J, Rao P Kumar
Department of Ophthalmology and Visual Sciences, School of Medicine, Washington University in St. Louis, CB 8096, 660 S. Euclid, St. Louis, MO, 63110, USA.
J Ophthalmic Inflamm Infect. 2012 Dec;2(4):243-8. doi: 10.1007/s12348-012-0074-x. Epub 2012 Apr 25.
The purpose of this study is to report two cases of idiopathic uveitis with secondary epiretinal membrane (ERM) formation in order to describe histologic and immunohistochemical features that may help distinguish uveitic from idiopathic ERMs.
The study utilized a clinical case series and histopathological and immunohistochemical findings.
There was no identifiable etiology of inflammation in either case. Histology and immunohistochemistry demonstrated a mixture of abundant inflammatory cells, including lymphocytes, histiocytes, plasma cells, and occasional eosinophils, among a stromal matrix composed of glial elements and condensed vitreous, but no retinal pigment epithelium (RPE) was present. The relative proportions of the various inflammatory cell types were assessed with immunohistochemistry, and among the lymphocyte population, T cells predominated over B cells. In one of the cases, there was an abundance of histiocytes, consistent with granulomatous uveitis, which was later confirmed on histology of the enucleated globe.
Idiopathic ERM formation is thought to be secondary to glial cell migration that may require some involvement of RPE cells. The absence of RPE and abundance of inflammatory cells may be used to identify ERMs as secondary to uveitis.
本研究旨在报告两例伴有继发性视网膜前膜(ERM)形成的特发性葡萄膜炎病例,以描述有助于区分葡萄膜炎性与特发性视网膜前膜的组织学和免疫组化特征。
本研究采用临床病例系列以及组织病理学和免疫组化结果。
两例病例均未发现明确的炎症病因。组织学和免疫组化显示,在由神经胶质成分和浓缩玻璃体组成的基质中,有大量炎性细胞混合存在,包括淋巴细胞、组织细胞、浆细胞,偶尔还有嗜酸性粒细胞,但未见视网膜色素上皮(RPE)。通过免疫组化评估了各种炎性细胞类型的相对比例,在淋巴细胞群体中,T细胞多于B细胞。其中一例有大量组织细胞,符合肉芽肿性葡萄膜炎,这在摘除眼球的组织学检查中得到了证实。
特发性视网膜前膜形成被认为是神经胶质细胞迁移的继发性结果,可能需要RPE细胞的某种参与。RPE的缺失和炎性细胞的大量存在可用于将视网膜前膜识别为葡萄膜炎的继发性病变。