Dua H S, Watson N J, Mathur R M, Forrester J V
Research Division, Wills Eye Hospital, Philadelphia, PA 19107.
Eye (Lond). 1993;7 ( Pt 1):53-8. doi: 10.1038/eye.1993.12.
Replicative turnover of the corneal epithelium is believed to occur from a population of stem cells located at the corneo-scleral limbus. During the healing of corneal epithelial wounds, sheets of epithelial cells move centripetally from the limbus and circumferentially along the limbus to cover the defect. A whorled or vortex pattern, similar to that seen in cornea verticillata, has been reported to occur on the corneal surface as an effect of topical steroid medication, during the healing of grafted corneas. This condition has been termed 'hurricane keratopathy'. We have noted this appearance in 6 patients who did not have corneal grafts. In all our patients the whorled pattern was best visible on fluorescein staining. This feature differentiates 'hurricane keratopathy' from cornea verticillata secondary to deposition of substances in corneal epithelial cells. Further, in all our patients the vortex was clockwise. Examination of illustrations of 'hurricane keratopathy' and cornea verticillata reported in the literature reveals that the whorled pattern is almost always clockwise. We believe that this specific pattern is likely to be due to the effect of the electromagnetic fields of the eye on the migrating epithelial cells and present a theory to explain this phenomenon. In 3 eyes of 2 other patients with chronic epitheliopathies we observed a random distribution of cells that did not conform to any specific pattern. We have termed this condition 'blizzard keratopathy'.
角膜上皮的复制性更新被认为源于位于角膜缘的一群干细胞。在角膜上皮伤口愈合过程中，上皮细胞片从角膜缘向心性移动，并沿角膜缘周向移动以覆盖缺损。据报道，在移植角膜愈合期间，作为局部类固醇药物治疗的一种效应，角膜表面会出现一种类似于角膜涡状浑浊所见的漩涡状或涡状图案。这种情况被称为“飓风性角膜病变”。我们在6例未进行角膜移植的患者中注意到了这种表现。在我们所有的患者中，涡状图案在荧光素染色时最清晰可见。这一特征将“飓风性角膜病变”与角膜上皮细胞中物质沉积继发的角膜涡状浑浊区分开来。此外，在我们所有的患者中，漩涡都是顺时针方向的。对文献中报道的“飓风性角膜病变”和角膜涡状浑浊的插图进行检查发现，涡状图案几乎总是顺时针方向的。我们认为这种特定图案可能是由于眼睛的电磁场对迁移的上皮细胞的影响，并提出了一种理论来解释这一现象。在另外2例患有慢性上皮病变的患者的3只眼中，我们观察到细胞呈随机分布，不符合任何特定图案。我们将这种情况称为“暴风雪性角膜病变”。
