Küchle M, Nguyen N X, Hannappel E, Naumann G O
Department of Ophthalmology, University Erlangen-Nürnberg, Germany.
Ophthalmic Res. 1995;27 Suppl 1:136-42. doi: 10.1159/000267859.
Eyes with pseudoexfoliation syndrome (PEX) frequently show clinical signs of impairment of the blood-aqueous barrier. Herein we give an overview of recent studies that analyzed the blood-aqueous barrier in eyes with PEX.
The authors review and summarize recent studies including quantification of aqueous flare in eyes with PEX using the laser flare cell meter (LFCM; Kowa FC-1000) in comparison with normal eyes and eyes with primary open-angle glaucoma (POAG), quantification of aqueous flare in eyes with PEX with and without secondary open-angle glaucoma (SOAG), and quantitative biochemical determination of total aqueous protein concentration in PEX eyes. In addition, studies of noninvasive quantification of the blood-aqueous barrier breakdown following trabeculectomy and following phacoemulsification with intraocular lens implantation in eyes with and without PEX are reviewed.
In eyes with manifest PEX, both aqueous flare and aqueous protein concentration were significantly increased in comparison with normal control eyes and eyes with POAG. Flare values in PEX eyes with SOAG were not significantly different from flare values in PEX eyes without SOAG. Following trabeculectomy as well as following cataract surgery, breakdown of the blood-aqueous barrier as determined by quantification of aqueous flare was significantly higher in eyes with PEX than in eyes without PEX.
Impairment of the blood-aqueous barrier with increase in aqueous protein concentration is a feature of PEX and may be quantified both by flare measurement and by biochemical protein determination. The extensive blood-aqueous barrier breakdown in eyes with PEX following intraocular surgery is an important risk factor for early or late postoperative complications. The alterations of the blood-aqueous barrier should be considered in the medical and surgical treatment of eyes with PEX.
假性剥脱综合征（PEX）患者的眼睛常常出现血-房水屏障受损的临床体征。在此，我们概述了近期分析PEX患者眼睛血-房水屏障的研究。
作者回顾并总结了近期的研究，包括使用激光散射细胞仪（LFCM；Kowa FC - 1000）对PEX患者眼睛的房水闪光进行定量，并与正常眼睛和原发性开角型青光眼（POAG）患者的眼睛进行比较；对伴有和不伴有继发性开角型青光眼（SOAG）的PEX患者眼睛的房水闪光进行定量；以及对PEX患者眼睛房水总蛋白浓度进行定量生化测定。此外，还回顾了对伴有和不伴有PEX的眼睛在小梁切除术后以及白内障超声乳化联合人工晶状体植入术后血-房水屏障破坏进行无创定量的研究。
与正常对照眼睛和POAG患者的眼睛相比，明显患有PEX的患者眼睛的房水闪光和房水蛋白浓度均显著升高。伴有SOAG的PEX患者眼睛的闪光值与不伴有SOAG的PEX患者眼睛的闪光值无显著差异。在小梁切除术后以及白内障手术后，通过房水闪光定量测定，PEX患者眼睛的血-房水屏障破坏程度显著高于非PEX患者的眼睛。
血-房水屏障受损伴房水蛋白浓度升高是PEX的一个特征，可通过闪光测量和生化蛋白测定进行量化。PEX患者眼睛在眼内手术后广泛的血-房水屏障破坏是术后早期或晚期并发症的重要危险因素。在对PEX患者眼睛进行药物和手术治疗时，应考虑血-房水屏障的改变。
