Schmidt H H, Diekstall F F, Bojanovski D, Manns M P
Abteilung Gastroenterologie und Hepatologie, Medizinischen Hochschule Hannover.
Dtsch Med Wochenschr. 1994 Oct 14;119(41):1393-6. doi: 10.1055/s-2008-1058851.
A 67-year-old man complained of impaired vision at night for several months. He was known to have arcus senilis (arcus lipoides corneae) since aged 21 years. For the last 20 years both corneas had become progressively more cloudy. His mother was said to have had similar eye changes. Ophthalmological examination discovered no abnormality other than marked corneal dystrophy with hardly separable arcus senilis. General physical examination was normal. Total cholesterol and triglyceride levels in serum were within normal limits, but serum concentration of high density lipoprotein (HDL) cholesterol (8 mg/dl) was reduced as were, within the high density lipoprotein fraction, the concentrations of triglyceride (4 mg/dl), phospholipids (38 mg/dl), the proportion of cholesterol esters (31%), and the cholesterol-esterification rate (51 nmol/ml . h). The HDL-associated activity of lecithin-cholesterol-acetyltransferase activity was scarcely measurable (0.9 nmol/ml . h). The signs in this case (cloudy cornea, marked decrease in serum HDL cholesterol concentration without premature arteriosclerosis) are typical of fish eye disease.
一名67岁男性主诉夜间视力受损数月。他自21岁起就患有角膜弓（角膜脂环）。在过去20年里，双眼角膜逐渐变得更加浑浊。据说他的母亲也有类似的眼部变化。眼科检查除了发现明显的角膜营养不良且角膜弓几乎无法分离外，未发现其他异常。全身体格检查正常。血清总胆固醇和甘油三酯水平在正常范围内，但血清高密度脂蛋白（HDL）胆固醇浓度（8毫克/分升）降低，在高密度脂蛋白组分中，甘油三酯浓度（4毫克/分升）、磷脂浓度（38毫克/分升）、胆固醇酯比例（31%）以及胆固醇酯化率（51纳摩尔/毫升·小时）也降低。与HDL相关的卵磷脂 - 胆固醇 - 乙酰转移酶活性几乎无法检测到（0.9纳摩尔/毫升·小时）。该病例中的体征（角膜浑浊、血清HDL胆固醇浓度显著降低且无过早动脉硬化）是鱼眼病的典型表现。
