Ismail H I H, Ashour D S, Abou Rayia D M, Ali A L
Departments ofMedical Parasitology and.
Ophthalmology, Faculty of Medicine,Tanta University,Tanta,Egypt.
J Helminthol. 2016 Nov;90(6):773-778. doi: 10.1017/S0022149X1500111X. Epub 2016 Feb 17.
Ocular lesions have been reported in patients with schistosomiasis; however, the problem with studying schistosomal infection of the human eye is that biopsies are almost impossible to take, and histopathological examination of suspicious lesions can only be undertaken post-mortem or after enucleation. This work aimed to study the possible effects and pathogenesis of schistosomiasis on the eye. This study involved 55 hamsters; five hamsters remained non-infected and the remaining 50 hamsters were infected with Schistosoma mansoni cercariae. Infected hamsters were sacrificed on weeks 8, 12, 16 and 20 post-infection (pi). Eye sections were prepared and stained for histopathological and immunohistochemical studies. Histopathological changes detected in hamsters infected after 16 and 20 weeks included looseness and oedema of the innermost retinal layers together with hyperplastic polypoid growth. Neither eggs nor granulomata were detected in eye sections throughout the experimental period. Deposition of S. mansoni antigen was revealed in 35% of infected hamsters. Later, on weeks 16 and 20 pi, moderate subepithelial conjuctival deposits and marked subchoroidal and scleral deposition were detected. In conclusion, the deposition of schistosomal antigen and immune complexes may play a pivotal role in the ocular changes that occur in schistosomiasis, even in the absence of detectable Schistosoma eggs. Schistosomiasis should be suspected in cases with unexplained ophthalmological findings, especially in endemic areas.
已有报告称血吸虫病患者存在眼部病变;然而,研究人类眼部血吸虫感染的问题在于几乎无法进行活检,可疑病变的组织病理学检查只能在尸检或眼球摘除后进行。这项工作旨在研究血吸虫病对眼睛可能产生的影响及发病机制。本研究涉及55只仓鼠;5只仓鼠未感染,其余50只仓鼠感染曼氏血吸虫尾蚴。在感染后第8、12、16和20周处死感染的仓鼠。制备眼部切片并进行染色,用于组织病理学和免疫组织化学研究。在感染16周和20周后的仓鼠中检测到的组织病理学变化包括最内层视网膜层的疏松和水肿以及增生性息肉样生长。在整个实验期间,眼部切片中均未检测到虫卵或肉芽肿。在35%的感染仓鼠中发现了曼氏血吸虫抗原的沉积。随后,在感染后第16周和20周,检测到中度上皮下结膜沉积以及明显的脉络膜下和巩膜沉积。总之,血吸虫抗原和免疫复合物的沉积可能在血吸虫病眼部病变中起关键作用,即使在未检测到血吸虫卵的情况下也是如此。对于有无法解释的眼科检查结果的病例,尤其是在流行地区,应怀疑患有血吸虫病。