Lui Forshing, Stokkermans Thomas J.
CA Northstate Uni, College of Med
University Hospitals of Cleveland
Heterochromia or heterochromia iridum indicates a difference between the color of the two irises. It can involve the whole iris or only part of the iris (sectoral heterochromia). It is easier to understand the determinants of iris color with the anatomy of the iris in mind. The iris and the ciliary body constitute the anterior uveal coat. The iris is composed of two anatomical layers that both contain pigment. The iris stroma is the anterior layer, consisting of loose collagenous connective tissue, the sphincter and dilator pupillae muscles, blood vessels, nerves, melanocytes, and other cells. The posterior layer (the iris pigment epithelium) consists of two layers of cuboidal epithelium. The pigment epithelium layer is derived embryologically from the anterior part of the optic cup, and hence neuroectodermal in origin. The iris stroma is mainly mesenchymal in origin. The melanocytes within the iris stroma and the ciliary body are all derived from neurocrest cells. Another important concept is the amount, type, and location of the pigment present. A type of cell called a melanocyte produces melanin that is deposited in melanosomes. Variation in the number of melanosomes and the amount of pigment in each melanosome present in the anterior iris stroma determines eye color. The type of pigment affects eye color as well. The main two types of pigment are eumelanin (brown to black pigment) and pheomelanin (red to yellow pigment). Eumelanin is present in the iris pigment epithelium, while both eumelanin and pheomelanin are present in the iris stroma. Lipofuscin (yellow in appearance) can accumulate with age and/or ocular disease. Eumelanin is present in the iris, brain, and hair and comes in a brown and black form. Pheomelanin is present in the iris, hair, lips, nipples, glans penis, and vagina and comes in a red and yellow form. The relative presence of the different types of eumelanin and pheomelanin determines both hair and iris color. Both groups of pigment form from L-tyrosine that is converted to L-dopaquinone by tyrosinase. Tyrosinase-related protein-1, in turn, converts L-dopaquinone to eumelanin while the addition of cysteine forms pheomelanin. Genetics plays an important role in determining eye color, with up to 150 genes involved and two genes, OCA2 and HERC2, on chromosome 15, playing a significant role. OCA2 produces "P protein," which promotes melanosome maturation, and HERC2, in turn, controls OCA2. The inheritance of iris color is largely determined by two genes as well, EYCL1 (also called the gey gene) and EYCL3 (also called the bey2 gene). The gey gene has a green and blue allele, and the bey2 gene has a brown and blue allele. The brown allele is dominant over the green allele, and both are dominant over the blue allele. Since many other genes play a role as well, this occasionally creates unexpected iris color. Congenital heterochromia can be inherited, and autosomal dominant inheritance has been reported. In many cases, however, genetic mosaicism occurs when genetic recombination or a mutation occurs during mitosis, creating an organism with genetically different cells. In albinism, both the iris stroma and the iris pigment epithelium are affected. Oculocutaneous albinism is inherited in an autosomal recessive manner and caused by mutations in tyrosinase, tyrosinase-related protein-1, and OCA2. Ocular albinism is inherited in a sex-linked recessive manner. Eye color changes from lighter tints to darker during the first year of life, with most changes occurring between 3 and 6 months of age. These changes are dependent on adrenergic innervation. Horner syndrome's lack of adrenergic innervation causes a lighter-colored iris that will have a smaller pupil in dark conditions. Other structures within the iris and elsewhere may affect the color of the iris as well. First, iris atrophy from conditions such as pigment dispersion syndrome as well as an iridocorneal endothelial syndrome, and iris damage such as caused by surgery or injury can cause heterochromia. Second, anisocoria (different pupil size), which can result from ocular trauma, Adie's pupil, or Horner syndrome, or an abnormal pupil such as is the case with iris coloboma, can create the impression of heterochromia. Neoplastic or hamartomas structures within the iris such as iris naevi and Lisch nodules can cause heterochromia as well. Finally, asymmetrical corneal changes such as band keratopathy, scarring, or edema can create the impression of heterochromia. Finally, several optical phenomena and light conditions can affect the appearance of the iris. For example, reduced ambient light can cause an amber eye to appear brown. Selective absorption and reflection of other (non-pigment) molecules such as hemoglobin and collagen describe most of the variations in eye color that are not attributed to pigmentation of the iris. However, Rayleigh (causing the blue appearance of the sky) and Tyndall scattering, as well as diffraction, can contribute to eye color as well. Raman scattering and constructive interference (responsible for the coloration of bird and butterfly feathers and brightly colored irises of many animals) do not play a role in human iris coloration. In addition to the color, human iris tissue may form complex patterns with distinct features. These distinct features can be used for automatic personal identification like fingerprints.
异色症或虹膜异色症是指两眼虹膜颜色不同。它可累及整个虹膜或仅累及虹膜的一部分(扇形异色症)。结合虹膜的解剖结构来理解虹膜颜色的决定因素会更容易。虹膜和睫状体构成眼前葡萄膜。虹膜由两个均含有色素的解剖层组成。虹膜基质是前层,由疏松的胶原结缔组织、瞳孔括约肌和开大肌、血管、神经、黑素细胞及其他细胞组成。后层(虹膜色素上皮)由两层立方上皮组成。色素上皮层在胚胎学上起源于视杯前部,因此起源于神经外胚层。虹膜基质主要起源于间充质。虹膜基质和睫状体内的黑素细胞均起源于神经嵴细胞。另一个重要概念是所存在色素的数量、类型和位置。一种名为黑素细胞的细胞产生黑色素,黑色素沉积在黑素小体中。前虹膜基质中黑素小体数量的变化以及每个黑素小体中色素的含量决定了眼睛的颜色。色素的类型也会影响眼睛的颜色。主要的两种色素是真黑素(棕色至黑色色素)和褐黑素(红色至黄色色素)。真黑素存在于虹膜色素上皮中,而真黑素和褐黑素都存在于虹膜基质中。脂褐素(外观呈黄色)会随着年龄增长和/或眼部疾病而积累。真黑素存在于虹膜、大脑和头发中,有棕色和黑色两种形式。褐黑素存在于虹膜、头发、嘴唇、乳头、阴茎头和阴道中,有红色和黄色两种形式。不同类型真黑素和褐黑素的相对含量决定了头发和虹膜的颜色。这两类色素均由L - 酪氨酸形成,酪氨酸在酪氨酸酶的作用下转化为L - 多巴醌。酪氨酸酶相关蛋白 - 1进而将L - 多巴醌转化为真黑素,而添加半胱氨酸则形成褐黑素。遗传学在决定眼睛颜色方面起着重要作用,涉及多达150个基因,其中位于15号染色体上的OCA2和HERC2这两个基因发挥着重要作用。OCA2产生“P蛋白”,促进黑素小体成熟,而HERC2则控制OCA2。虹膜颜色的遗传很大程度上也由两个基因决定,即EYCL1(也称为gey基因)和EYCL3(也称为bey2基因)。gey基因有绿色和蓝色等位基因,bey2基因有棕色和蓝色等位基因。棕色等位基因对绿色等位基因呈显性,两者对蓝色等位基因均呈显性。由于许多其他基因也发挥作用,这偶尔会导致出现意想不到的虹膜颜色。先天性异色症可以遗传,已有常染色体显性遗传的报道。然而,在许多情况下,当有丝分裂期间发生基因重组或突变时会出现基因镶嵌现象,从而产生具有基因不同细胞的生物体。在白化病中,虹膜基质和虹膜色素上皮都会受到影响。眼皮肤白化病以常染色体隐性方式遗传,由酪氨酸酶、酪氨酸酶相关蛋白 - 1和OCA2的突变引起。眼部白化病以性连锁隐性方式遗传。在生命的第一年,眼睛颜色会从较浅色调变为较深色调,大多数变化发生在3至6个月大时。这些变化依赖于肾上腺素能神经支配。霍纳综合征缺乏肾上腺素能神经支配会导致虹膜颜色变浅,在黑暗条件下瞳孔会变小。虹膜内及其他部位的其他结构也可能影响虹膜的颜色。首先,色素播散综合征以及虹膜角膜内皮综合征等疾病导致的虹膜萎缩,以及手术或损伤引起的虹膜损伤可导致异色症。其次,瞳孔不等大(瞳孔大小不同),可由眼外伤、阿 - 罗氏瞳孔或霍纳综合征引起,或者像虹膜缺损那样的异常瞳孔,会造成异色症的假象。虹膜内的肿瘤性或错构瘤性结构,如虹膜痣和利氏结节,也可导致异色症。最后,不对称的角膜变化,如带状角膜病变、瘢痕形成或水肿,会造成异色症的假象。最后,几种光学现象和光照条件会影响虹膜的外观。例如,环境光减少会使琥珀色眼睛看起来呈棕色。血红蛋白和胶原蛋白等其他(非色素)分子的选择性吸收和反射描述了大多数并非归因于虹膜色素沉着的眼睛颜色变化。然而,瑞利散射(导致天空呈现蓝色)和廷德尔散射以及衍射也会影响眼睛颜色。拉曼散射和相长干涉(导致鸟类和蝴蝶的羽毛以及许多动物色彩鲜艳的虹膜着色)在人类虹膜颜色形成中不起作用。除了颜色,人类虹膜组织可能形成具有独特特征的复杂图案。这些独特特征可用于像指纹一样的自动个人识别。