Wroblewski Keith J, Hidayat Ahmed, Neafie Ron, Meyers Wayne
Walter Reed Army Military Medical Center, United States.
Armed Forces Institute of Pathology, United States.
Saudi J Ophthalmol. 2019 Jul-Sep;33(3):255-259. doi: 10.1016/j.sjopt.2019.09.003. Epub 2019 Sep 10.
To investigate the Armed Forces Institute of Pathology (AFIP) experience with Ocular Leprosy.
The AFIP data banks were screened for cases with diagnosis of ocular leprosy. Files and slides stained with Hematoxylin-eosin and acid-fast staining were reviewed by the Division of Ocular Pathology and by the Infectious Diseases Pathology Branch.
Twenty-five cases were found from 1951 to 1985 and there were 15 males and 7 females and in 3 cases the sex was not given. The disease process ran from 4 months to 50 years in this series. Three patients also had systemic mycobacterium tuberculosis infections. The clinical manifestations of leprosy did not correlate with the histopathological findings. Clinically, corneal manifestations were the most common clinical presentation in 15 cases with only one perforation, iridocyclitis following in 9 patients and eyelid abnormalities ranging from ectropion to trichiasis in 7 patients. Two patients at autopsy had lepromatous cells in the ciliary body as the only ocular manifestation.
In summary, this paper represents a series of ocular leprosy cases from the AFIP which shows the severity of ocular involvement, the predilection of anterior segment involvement and a large number of histopathologic indeterminate cases. The current immigrant and refugee crisis warrants revisting this ancient disease in the differential diagnosis.
调查武装部队病理研究所（AFIP）在眼部麻风病方面的经验。
在AFIP数据库中筛查诊断为眼部麻风病的病例。眼部病理科和传染病病理科对苏木精-伊红染色和抗酸染色的档案及玻片进行了复查。
1951年至1985年共发现25例，其中男性15例，女性7例，3例未注明性别。该系列病例病程从4个月至50年不等。3例患者还患有全身性结核分枝杆菌感染。麻风病的临床表现与组织病理学结果不相关。临床上，角膜表现是最常见的临床表现，15例中有1例角膜穿孔，9例患者发生虹膜睫状体炎，7例患者有眼睑异常，从睑外翻到倒睫。2例尸检患者的睫状体中有麻风细胞，这是唯一的眼部表现。
总之，本文介绍了AFIP的一系列眼部麻风病病例，显示了眼部受累的严重程度、前段受累的倾向以及大量组织病理学诊断不明确的病例。当前的移民和难民危机促使我们在鉴别诊断中重新审视这种古老的疾病。
