Malaty R, Togni B
Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco.
Invest Ophthalmol Vis Sci. 1988 Jan;29(1):140-5.
Leprosy is the third leading cause of blindness worldwide; however, little is known about the ocular changes that occur during the disease process. We have studied the eyes of two nine-banded armadillos with experimental Mycobacterium leprae infection by light and electron microscopy. Both animals had been inoculated intracutaneously, one 5 years and the other 2 years previously. Light microscopy revealed invasion by acid-fast bacilli which were seen in keratocytes and mononuclear phagocytes in all layers of the corneal stroma. In both animals, large macrophage granulomas were observed in the deep stroma, which was vascularized. Acid-fast bacilli were also were found in macrophages and vascular endothelial cells. By electron microscopy, numerous bacilli were found in the keratocytes, macrophages, and Schwann cells of myelinated and unmyelinated axons, and in the endothelial cells of blood vessels. The localization of M. leprae and the presence of inflammatory cells in the ocular tissue of both animals suggest that the bacilli reach the eye by the neural and/or vascular route. One animal showed much more extensive disease and bacillary yield than the other, indicating that ocular involvement may be independent of the generalized infection. Further studies of early ocular involvement in the armadillo and other animals could help to clarify the pathogenesis of this potentially blinding infection.
麻风病是全球第三大致盲原因；然而，对于疾病过程中发生的眼部变化知之甚少。我们通过光学显微镜和电子显微镜研究了两只感染实验性麻风分枝杆菌的九带犰狳的眼睛。两只动物均为皮内接种，一只在5年前接种，另一只在2年前接种。光学显微镜显示抗酸杆菌侵入，在角膜基质各层的角膜细胞和单核吞噬细胞中可见。在两只动物中，在深部血管化的基质中均观察到大型巨噬细胞肉芽肿。在巨噬细胞和血管内皮细胞中也发现了抗酸杆菌。通过电子显微镜观察，在角膜细胞、巨噬细胞、有髓和无髓轴突的施万细胞以及血管内皮细胞中发现了大量杆菌。两只动物眼部组织中麻风分枝杆菌的定位和炎症细胞的存在表明，杆菌通过神经和/或血管途径到达眼睛。一只动物的疾病和杆菌产量比另一只广泛得多，表明眼部受累可能与全身性感染无关。对犰狳和其他动物早期眼部受累的进一步研究可能有助于阐明这种潜在致盲感染的发病机制。
