Meisler D M, Langston R H, Naab T J, Aaby A A, McMahon J T, Tubbs R R
Am J Ophthalmol. 1984 Mar;97(3):337-43. doi: 10.1016/0002-9394(84)90633-0.
In three patients (three men, 44, 67, and 83 years old) an unusual keratopathy characterized by white, branching, crystalline stromal opacities produced lesions that were insidious, that increased in size slowly, and that were clinically and histopathologically associated with little corneal inflammation. Intraocular inflammation eventually became evident in two of the patients. The keratopathy developed while the patients were using topical corticosteroids. In two cases, histopathologic studies disclosed accumulations of gram-positive cocci in the corneal stroma; a viridans streptococcus agent was isolated on culture. In one case, the viridans streptococcus was determined to be a dextran producer, which may have contributed to the pathogenesis of the keratopathy. Despite aggressive treatment with a variety of drugs, epithelial healing, and resolution of the corneal infiltrate, residual scarring persisted in two cases and neovascularization and graft edema in one case each.
在3例患者（3名男性，年龄分别为44岁、67岁和83岁）中，一种以白色、分支状、结晶样基质混浊为特征的不寻常角膜病变产生了隐匿性病变，病变大小缓慢增加，且在临床和组织病理学上与轻微的角膜炎症相关。两名患者最终出现了眼内炎症。这种角膜病变是在患者使用局部皮质类固醇时发生的。在2例病例中，组织病理学研究显示角膜基质中有革兰氏阳性球菌聚集；培养分离出一株草绿色链球菌。在1例病例中，该草绿色链球菌被确定为葡聚糖产生菌，这可能促成了角膜病变的发病机制。尽管用多种药物进行了积极治疗，上皮愈合且角膜浸润消退，但2例病例仍有残留瘢痕，1例病例分别出现了新生血管和移植片水肿。
