Matoba A Y, O'Brien T P, Wilhelmus K R, Jones D B
Veterans Affairs Medical Center, Houston, TX.
Ophthalmology. 1994 Jun;101(6):1000-4. doi: 10.1016/s0161-6420(94)31229-2.
Infectious crystalline keratopathy is a distinctive clinical entity characterized by bacterial replication within the corena without inflammation. The authors report on a patient with infectious crystalline keratopathy due to Streptococcus pneumoniae serotype 11F. They used this isolate to study the contribution of the pneumococcal polysaccharide capsule to the pathogenesis of the infectious crystalline keratopathy.
Aliquots containing 10(6) colony-forming units of pneumococci serotype 11F, serogroup 9 or 15, were inoculated into New Zealand white rabbit corneas. The corneas were examined at 24, 48, and 72 hours. Representative corneas were excised at 24 hours and processed for histopathologic analysis.
Pauci-inflammatory crystalline lesions developed in all corneas inoculated with the serotype 11F ocular isolate by 24 hours. Suppurative keratitis developed in control corneas inoculated with serogroup 9 or 15 pneumococci. The nonocular 11F isolates produced lesions with some features compatible with infectious crystalline keratopathy.
Different pneumococcal serotypes vary in their ability to produce infectious crystalline keratopathy. Because serotype differences reflect differences in the antigenic polysaccharides of the bacterial capsule, this study suggests that properties of the pneumococcal capsule may influence the initial development of infectious crystalline keratopathy.
感染性结晶状角膜病变是一种独特的临床病症，其特征为细菌在角膜内复制而无炎症反应。作者报告了一例由11F血清型肺炎链球菌引起的感染性结晶状角膜病变患者。他们利用该分离株研究肺炎球菌多糖荚膜在感染性结晶状角膜病变发病机制中的作用。
将含有10⁶个11F血清型、9或15血清群肺炎球菌菌落形成单位的等分试样接种到新西兰白兔角膜中。在24、48和72小时时检查角膜。在24小时时切除代表性角膜并进行组织病理学分析。
到24小时时，接种11F血清型眼部分离株的所有角膜均出现轻度炎症性结晶病变。接种9或15血清群肺炎球菌的对照角膜发生化脓性角膜炎。非眼部11F分离株产生的病变具有一些与感染性结晶状角膜病变相符的特征。
不同肺炎球菌血清型产生感染性结晶状角膜病变的能力不同。由于血清型差异反映了细菌荚膜抗原多糖的差异，本研究表明肺炎球菌荚膜的特性可能影响感染性结晶状角膜病变的初始发展。
