Bujara K, von Domarus D, Hinzpeter E N
Graefes Arch Clin Exp Ophthalmol. 1982;219(4):198-203. doi: 10.1007/BF02156847.
Necrotic foci within the iris and ciliary body were present in 104 eyes examined at the histopathological laboratory of the University Eye Clinic, Hamburg. Three different aetiological mechanisms were found: 1) Vascular acute glaucoma, diminished arterial supply, or radiogenic occlusive vasculitis can lead to ischaemic infarction. 2) Inflammatory: direct contact with the noxious agent can lead to cell death, either via liberation of toxines and enzymes--usually bacterial--or due to direct cytotoxic effect, in case of viruses. Both can further cause cell death via immunological mechanisms. Intraocular suppurative bacterial infections predominate in this group. 3) Traumatic and operative: tissue damage is caused by mechanical or thermal injury. Besides accidental trauma, uveal necrosis also occurs frequently after surgical coagulation or dialysis of the ciliary body for glaucoma. The sequelae of iris and ciliary body necrosis depend on the extent of the damage. Small necrotic areas are followed by scarring, which has no injurious consequences on visual function. Widespread necrosis, on the other hand, is complicated by immediate atrophia bulbi or secondary angle-closure glaucoma with or without rubeosis iridis.
在汉堡大学眼科诊所的组织病理学实验室检查的104只眼中，虹膜和睫状体存在坏死灶。发现了三种不同的病因机制：1）血管性急性青光眼、动脉供应减少或放射性闭塞性血管炎可导致缺血性梗死。2）炎症性：与有害物质直接接触可导致细胞死亡，要么通过毒素和酶（通常是细菌）的释放，要么在病毒感染时由于直接细胞毒性作用。两者都可通过免疫机制进一步导致细胞死亡。该组中眼内化脓性细菌感染占主导。3）创伤性和手术性：组织损伤由机械或热损伤引起。除意外创伤外，青光眼患者在睫状体进行手术凝固或透析后，葡萄膜坏死也经常发生。虹膜和睫状体坏死的后遗症取决于损伤程度。小的坏死区域随后会形成瘢痕，对视觉功能没有损害性后果。另一方面，广泛的坏死会并发立即眼球萎缩或继发性闭角型青光眼，伴有或不伴有虹膜红变。
