Kalin N S, Orlin S E, Wulc A E, Heffler K F, Frayer W C, Sulewski M E, Mittra R A, Cavanagh H D
Scheie Eye Institute, University of Pennsylvania School of Medicine, Philadelphia 19104, USA.
Cornea. 1996 May;15(3):295-300. doi: 10.1097/00003226-199605000-00011.
Conjunctival chemosis is a commonly encountered clinical finding stemming from the presence of excess fluid in the conjunctiva. It is typically self-limiting or reversible if the underlying condition is treated. The authors present a series of seven cases of chronic localized conjunctival chemosis. Each patient had a localized area of dependent conjunctival edema for >or= 6 months. Evaluation of each patient included clinical examination, laboratory studies, and neuroimaging to attempt to elucidate the pathogenesis of the chemosis. Conjunctival biopsy was performed in six of the seven patients. In all of the patients studied, clinical examination uncovered no definitive signs of local inflammation. Laboratory evaluation was normal, and neuroimaging failed to confirm obstruction of venous or lymphatic drainage. Conjunctival biopsies showed chronic tissue inflammation or lymphangiectasia. The diagnosis of chronic localized conjunctival chemosis (CLCC) can be made if localized conjunctival edema persists for 6 months. Evaluation of biopsy specimens supports the theory that CLCC may result from scarring and structural alteration of conjunctival lymphatics, which appears to irreversibly affect the distribution of fluid in the conjunctiva.
结膜水肿是一种常见的临床体征，是由于结膜内存在过多液体所致。如果潜在病因得到治疗，它通常是自限性的或可逆的。作者报告了一系列7例慢性局限性结膜水肿病例。每位患者的结膜依赖性水肿局限区域均持续≥6个月。对每位患者的评估包括临床检查、实验室检查和神经影像学检查，以试图阐明水肿的发病机制。7例患者中有6例行结膜活检。在所有研究的患者中，临床检查未发现明确的局部炎症体征。实验室检查结果正常，神经影像学检查未能证实静脉或淋巴引流受阻。结膜活检显示慢性组织炎症或淋巴管扩张。如果局限性结膜水肿持续6个月，则可诊断为慢性局限性结膜水肿（CLCC）。对活检标本的评估支持这样一种理论，即CLCC可能是由结膜淋巴管的瘢痕形成和结构改变引起的，这似乎会不可逆地影响结膜内液体的分布。
