Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Chiba, Japan
Cornea Center Eye Bank, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Chiba, Japan.
BMJ Case Rep. 2020 Nov 3;13(11):e237417. doi: 10.1136/bcr-2020-237417.
This case series included two healthy adults who showed continuous production of acellular materials in the anterior chamber without inflammation. The materials were membrane-like in case 1 and amorphous in case 2; they gradually changed shape and location over several years. During follow-up, there were no changes in vision, the iris or the chamber angle. Anterior segment optical coherence tomography confirmed the attachment of the membrane to the corneal endothelium. Specular microscopy showed normal endothelial counting with reversal of the normal light/dark patterns that occasionally returned to normal appearances. Although acellular materials were observed unilaterally in both cases, abnormal endothelial images were noted in both eyes of case 1. Histopathological examinations demonstrated the absence of cellular components with negative immunostaining for collagen IV, vimentin and α-smooth muscle actin. Serial ophthalmic examinations and histopathological findings suggest that the production of acellular material was associated with alterations of the corneal endothelium.
本病例系列纳入了两名健康成年人，他们的前房内持续产生无炎症的去细胞物质。病例 1 的物质呈膜状，病例 2 的物质呈无定形；这些物质在数年内逐渐改变形状和位置。随访期间，视力、虹膜或房角均无变化。眼前节光学相干断层扫描证实了膜与角膜内皮的附着。共焦显微镜显示内皮细胞计数正常，正常的明暗模式反转，偶尔恢复正常外观。尽管这两例均为单侧出现去细胞物质，但病例 1 的双眼均出现了异常的内皮图像。组织病理学检查显示无细胞成分，Ⅳ型胶原、波形蛋白和α-平滑肌肌动蛋白免疫染色阴性。连续的眼科检查和组织病理学发现提示，去细胞物质的产生与角膜内皮的改变有关。
