Wu Mengliang, Wang Xiaochun, Shao Tingting, Wang Yan
1Department of Ophthalmology, The Eye & ENT Hospital of Fudan University, Shanghai, China 2Ophthalmology Department of Zaozhuang Municipal Hospital, Zaozhuang, Shandong, China *
Optom Vis Sci. 2017 Nov;94(11):1066-1069. doi: 10.1097/OPX.0000000000001133.
This report details the natural history of corneal argyrosis over 3 years using in vivo confocal microscopy to document regression of hyperreflective deposits, as well as effects on corneal nerves and endothelial cell morphology.
To report the in vivo confocal microscopic features and clinical characteristics of a case of bilateral corneal argyrosis.
A 52-year-old man referred to us 3 months following cautery of the palpebral conjunctiva of both eyes with a silver nitrate stick was observed over the course of 3 years, during which slit-lamp photography and in vivo confocal microscopy were performed. At the first visit, slit-lamp examination showed a light blue-green discoloration and a thick, yellow, oval discoloration in the right and left cornea, respectively. One year later, under slit-lamp examination, the right cornea appeared nearly transparent, and the discoloration in the left cornea had remarkably regressed. In vivo confocal microscopy done at that time showed highly reflective deposits in Descemet membrane of the right cornea and throughout Bowman layer, the stroma, and Descemet membrane of the left cornea. Three years later, no accumulation of silver was observed during slit-lamp examination of either eye. In vivo confocal microscopy of the right cornea did not reveal any silver deposits, and the corneal structure appeared normal. In the left cornea, some silver deposits were still evident in Descemet membrane, and alterations of corneal nerve and endothelial cell morphology were also evident.
This report reviews the 3-year natural history of a patient with corneal argyrosis. In vivo confocal microscopy demonstrates that over time the corneal argyrosis gradually resolves without any treatment. However, the presence of silver in the cornea may impact the corneal nerves and endothelial cells.
本报告详细介绍了角膜银沉着症3年的自然病程，采用活体共聚焦显微镜记录高反射沉积物的消退情况，以及对角膜神经和内皮细胞形态的影响。
报告一例双侧角膜银沉着症的活体共聚焦显微镜特征和临床特点。
一名52岁男性，在双眼睑结膜用硝酸银棒烧灼3个月后转诊至我院，在3年期间进行观察，期间进行了裂隙灯照相和活体共聚焦显微镜检查。初诊时，裂隙灯检查显示右眼角膜呈浅蓝色-绿色变色，左眼角膜呈厚的黄色椭圆形变色。1年后，裂隙灯检查显示右眼角膜几乎透明，左眼角膜的变色明显消退。当时进行的活体共聚焦显微镜检查显示，右眼角膜后弹力层有高反射沉积物，左眼角膜的整个Bowman层、基质和后弹力层均有高反射沉积物。3年后，双眼裂隙灯检查均未观察到银的沉积。右眼角膜的活体共聚焦显微镜检查未发现任何银沉积物，角膜结构正常。在左眼，后弹力层仍有一些银沉积物，角膜神经和内皮细胞形态的改变也很明显。
本报告回顾了一名角膜银沉着症患者的3年自然病程。活体共聚焦显微镜检查表明，随着时间的推移，角膜银沉着症在未经任何治疗的情况下逐渐消退。然而，角膜中银的存在可能会影响角膜神经和内皮细胞。
