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病例报告:角膜氯丙嗪中毒药物沉积物的共聚焦显微镜检查

Case Report: IVCM of corneal chlorpromazine toxicity drug deposits.

作者信息

Xiao Xianwen, Fang Xie, Xie Zhiwen, Luo Shunrong, Lin Yuan, Wu Huping

机构信息

Xiamen Eye Center and Eye Institute of Xiamen University, School of Medicine, Xiamen, China.

Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China.

出版信息

Front Med (Lausanne). 2025 Aug 20;12:1614699. doi: 10.3389/fmed.2025.1614699. eCollection 2025.

Abstract

To investigate corneal deposits in a patient undergoing long-term chlorpromazine therapy using confocal microscopy with the HRT II Rostock Corneal Module. We reported a 45-year-old woman with a 7-year history of chlorpromazine therapy presented with bilateral photophobia and a 4-year history of gradual-onset blurred vision. Slit-lamp examination revealed yellowish deposits in the corneal endothelium and Descemet's membrane. confocal microscopy identified irregular hyper-reflective deposits in all corneal layers. The epithelial and superficial stromal deposits had well-defined edges, while the posterior stromal, Descemet's membrane, and endothelial deposits appeared as hollow granules and streaks. This study is the first to use confocal microscopy to identify crystalline deposits in the corneal stroma and endothelium caused by high-dose chlorpromazine. These findings offer new insights into drug metabolism on the ocular surface and provide a basis for future research.

摘要

使用配备HRT II Rostock角膜模块的共聚焦显微镜,对一名接受长期氯丙嗪治疗的患者的角膜沉积物进行研究。我们报告了一名45岁女性,有7年氯丙嗪治疗史,出现双侧畏光,并有4年逐渐出现的视力模糊病史。裂隙灯检查发现角膜内皮和后弹力层有淡黄色沉积物。共聚焦显微镜检查发现所有角膜层均有不规则的高反射沉积物。上皮和浅层基质沉积物边缘清晰,而后层基质、后弹力层和内皮沉积物表现为空心颗粒和条纹。本研究首次使用共聚焦显微镜识别高剂量氯丙嗪引起的角膜基质和内皮中的结晶沉积物。这些发现为眼表药物代谢提供了新的见解,并为未来的研究提供了基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4679/12405451/355d321a1dbf/fmed-12-1614699-g001.jpg

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