Repo L P, Naukkarinen A, Paljärvi L, Teräsvirta M E
Department of Ophthalmology, Kuopio University Hospital, Finland.
Graefes Arch Clin Exp Ophthalmol. 1996 Mar;234(3):171-6. doi: 10.1007/BF00462029.
The study was carried out to examine histological changes in the iris sphincter muscle and surrounding tissue in eyes with pseudoexfoliation syndrome (PXS).
Seventeen patients with PXS, 14 of them having capsular glaucoma, were enrolled into the study. Iris biopsies were obtained during extracapsular cataract extractions (ECCE) requiring sphincterotomies. Thirteen biopsy specimens underwent histological examination by light microscopy, and four were examined with the electron microscope. Three iris biopsies from cadaver eyes and one obtained during ECCE from a patient with a miotic pupil (no PXS) served as control specimens on light microscopy. Electron microscopic controls included three iris specimens from cadavers.
In the light microscopic examination, blood vessel walls were stained with Congo Red in seven of the 13 PXS specimens. In three of these seven specimens the stromal tissue was extensively fibrotized, and in two specimens fibrosis was moderate. Distinct stromal fibrosis was also observed in one and moderate fibrosis in two PXS specimens negative for amyloid. The control specimens were not positive for Congo Red, but stromal tissue was moderately fibrotized in one specimen. Light microscopy did not reveal differences in muscle tissue between PXS and control specimens. Electron microscopically, however, the muscle tissue was fibrotic or disorganized in three PXS specimens and in one control specimen. Fibrils, similar to the fibrillar component of pseudoexfoliation material described in previous studies, were found in intimate association with the capillary basal lamina in all of the PXS specimens showing muscular fibrosis.
These findings support the theory that PXS is associated with amyloid, and in some PXS eyes miosis is connected with degenerative changes both in the stromal tissue and in the muscular layer of the iris.
本研究旨在检查假性剥脱综合征（PXS）患者眼睛的虹膜括约肌和周围组织的组织学变化。
17例PXS患者纳入研究，其中14例患有晶状体囊膜性青光眼。在需要进行括约肌切开术的囊外白内障摘除术（ECCE）期间获取虹膜活检标本。13个活检标本进行了光学显微镜组织学检查，4个进行了电子显微镜检查。3个来自尸体眼睛的虹膜活检标本和1个在ECCE期间从瞳孔缩小（无PXS）患者获取的标本用作光学显微镜检查的对照标本。电子显微镜对照包括3个来自尸体的虹膜标本。
在光学显微镜检查中，13个PXS标本中有7个的血管壁被刚果红染色。在这7个标本中的3个，基质组织广泛纤维化，2个标本纤维化程度中等。在1个淀粉样蛋白阴性的PXS标本中也观察到明显的基质纤维化，2个标本中纤维化程度中等。对照标本刚果红染色阴性，但1个标本的基质组织有中度纤维化。光学显微镜未显示PXS标本和对照标本在肌肉组织方面存在差异。然而，在电子显微镜下，3个PXS标本和1个对照标本的肌肉组织出现纤维化或结构紊乱。在所有显示肌肉纤维化的PXS标本中，发现与毛细血管基膜紧密相连的纤维，类似于先前研究中描述的假性剥脱物质的纤维成分。
这些发现支持PXS与淀粉样蛋白有关的理论，并且在一些PXS眼中，瞳孔缩小与虹膜基质组织和肌肉层的退行性变化有关。
