Tagami N, Uyama M, Yamada K, Kosaki J, Ohkuma H, Tomoda T
Department of Ophthalmology, Kansai Medical University, Moriguchi, Japan.
Nippon Ganka Gakkai Zasshi. 1993 Feb;97(2):268-74.
The author performed sclerectomy in six cases of uveal effusion syndrome and examined the excised sclera histologically. From the findings of the sclera during the surgery and histological findings of the excised sclera, uveal effusion syndrome was divided into three groups: 1) nanophthalmos, 2) non-nanophthalmos with hypertrophic sclera, 3) non-nanophthalmos with normal thick sclera. In all cases, glycosaminoglycans were found to be deposited around the scleral collagen fibers. In the nanophthalmic eyes (group 1) and non-nanophthalmic eyes with the hypertrophic sclera (group 2), much glycosaminoglycans were demonstrated around the collagen bundles and enlarged the collagen bundle spaces. In these groups, sclerectomy procedures were successful and, based on the successful result of the operation, the cause of uveal effusion was considered to be disturbance of outflow of intraocular fluid through the hypertrophic sclera. In non-nanophthalmic eyes with normal thick sclera (group 3), few glycosaminoglycans was demonstrated around the collagen bundles with less abnormality, and sclerectomy procedure was not effective. In this group, the occurrence of uveal effusion was another cause but abnormal sclera.
作者对6例葡萄膜渗漏综合征患者实施了巩膜切除术,并对切除的巩膜进行了组织学检查。根据手术中巩膜的表现及切除巩膜的组织学检查结果,将葡萄膜渗漏综合征分为三组:1)小眼球;2)巩膜肥厚的非小眼球;3)巩膜厚度正常的非小眼球。在所有病例中,均发现糖胺聚糖沉积于巩膜胶原纤维周围。在小眼球组(第1组)和巩膜肥厚的非小眼球组(第2组),胶原束周围可见大量糖胺聚糖,使胶原束间隙增宽。在这些组中,巩膜切除手术取得成功,基于手术的成功结果,葡萄膜渗漏的原因被认为是眼内液通过肥厚巩膜的流出受阻。在巩膜厚度正常的非小眼球组(第3组),胶原束周围糖胺聚糖较少,异常程度较轻,巩膜切除手术无效。在该组中,葡萄膜渗漏的发生另有原因而非巩膜异常。