Wu J S, Lewis H, Fine S L, Grover D A, Green W R
Eye Pathology Laboratory, Johns Hopkins Hospital, Baltimore, MD 21205.
Retina. 1989;9(4):292-301. doi: 10.1097/00006982-198909040-00010.
We present the ocular clinicopathologic features of the left eye of a patient who, during a 29-year period, developed the characteristic features of progressive serpiginous choroiditis. Two areas of choroidal neovascularization were successfully treated by laser photocoagulation. The larger area of neovascularization, located in and inferior to the maculopapillary bundle area and treated with argon laser, resulted in a scar composed of hyperplastic retinal pigment with persistence of neovascularization and full-thickness destruction of the retina. A smaller area of neovascularization, located temporal to the fovea and treated by krypton laser, resulted in a fibrous scar with obliteration of the new vessels and preservation of the inner retinal layers. A diffuse and focal infiltrate of lymphocytes was present in the choroid. Often, larger aggregates of lymphocytes were present at the margin of the serpiginous lesions. The serpiginous lesions were characterized by loss of retinal pigment epithelium and the photoreceptor cell layer. The margins of most lesions had variable degrees of hyperplastic retinal pigment epithelium and some had defects in Bruch's membrane, through which fibroglial scar tissue extended into the choroid.
我们报告了一名患者左眼的眼部临床病理特征，该患者在29年期间出现了进行性匐行性脉络膜炎的特征性表现。两个脉络膜新生血管区域通过激光光凝成功治疗。较大的新生血管区域位于黄斑乳头束区域及其下方，用氩激光治疗，形成了一个由增生性视网膜色素组成的瘢痕，新生血管持续存在，视网膜全层破坏。较小的新生血管区域位于黄斑颞侧，用氪激光治疗，形成了一个纤维瘢痕，新生血管闭塞，视网膜内层得以保留。脉络膜存在弥漫性和局灶性淋巴细胞浸润。通常，在匐行性病变边缘存在较大的淋巴细胞聚集。匐行性病变的特征是视网膜色素上皮和光感受器细胞层缺失。大多数病变边缘有不同程度的增生性视网膜色素上皮，有些病变的 Bruch 膜有缺损，纤维胶质瘢痕组织通过该缺损延伸至脉络膜。
