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人眼视网膜脉络膜萎缩的电子显微镜研究。

Electron microscopic studies on retinochoroidal atrophy in the human eye.

作者信息

Okabe S, Matsuo N, Okamoto S, Kataoka H

出版信息

Acta Med Okayama. 1982 Feb;36(1):11-21. doi: 10.18926/AMO/30704.

Abstract

Nine eyeballs were enucleated from nine patients with excessive myopia, secondary retinochoroidal atrophy, absolute glaucoma, uveal malignant melanoma, Behçet's disease and sympathetic ophthalmia. The retina and choroid were studied with light and electron microscopes. The results were: In excessive myopia, marked blockade of choriocapillaries was accompanied by progressive retinal degeneration. In secondary retinochoroidal atrophy induced by retrobulbar fibrosis, the choriocapillaries were partially blocked and the retina had markedly degenerated. In Behçet's disease, exudative inflammation was recognized in the choroid extending to the retina and causing retinal detachment, though the choriocapillaries remained morphologically normal. In sympathetic ophthalmia, both the choriocapillaries and the retina remained normal, though marked inflammation was recognized in the outer layer of the choroid. In absolute glaucoma, the fine structures of the choriocapillary were well preserved in spite of bulbar hypertonia. In uveal malignant melanoma, the ultra structure of the choriocapillary near the tumor was well preserved. The choriocapillaries were normal even when the retina had degenerated. Retinal degeneration was recognized when changes such as blockage, disappearance, dilatation and increased permeability were found in the choriocapillaries. Damage to the choriocapillaries might play an important role in inducing and developing retinochoroidal atrophy.

摘要

从9例患有高度近视、继发性视网膜脉络膜萎缩、绝对期青光眼、葡萄膜恶性黑色素瘤、白塞病和交感性眼炎的患者眼中摘除了9个眼球。用光镜和电镜对视网膜和脉络膜进行了研究。结果如下:在高度近视中,脉络膜毛细血管明显阻塞并伴有进行性视网膜变性。在球后纤维化引起的继发性视网膜脉络膜萎缩中,脉络膜毛细血管部分阻塞,视网膜明显变性。在白塞病中,脉络膜可见渗出性炎症,并蔓延至视网膜导致视网膜脱离,尽管脉络膜毛细血管形态上保持正常。在交感性眼炎中,尽管脉络膜外层有明显炎症,但脉络膜毛细血管和视网膜均保持正常。在绝对期青光眼中,尽管眼压升高,但脉络膜毛细血管的精细结构保存良好。在葡萄膜恶性黑色素瘤中,肿瘤附近的脉络膜毛细血管超微结构保存良好。即使视网膜已经变性,脉络膜毛细血管仍正常。当脉络膜毛细血管出现阻塞、消失、扩张和通透性增加等变化时,可发现视网膜变性。脉络膜毛细血管的损伤可能在视网膜脉络膜萎缩的发生和发展中起重要作用。

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