Kubota T, Schlötzer-Schrehardt U M, Naumann G O, Kohno T, Inomata H
Department of Ophthalmology, University Erlangen-Nürnberg, Germany.
Graefes Arch Clin Exp Ophthalmol. 1996 Jun;234(6):351-8. doi: 10.1007/BF00190710.
The present study was performed to investigate the ultrastructure of deep retinal layers and choroid corresponding to the parapapillary chorioretinal atrophy in eyes with secondary angle-closure glaucoma.
The glaucomatous eyes included two eyes enucleated due to iris ring melanoma with high intraocular pressure and one eye with neovascular glaucoma enucleated due to ocular pain. The control eyes included one eye enucleated due to choroidal malignant melanoma with normal intraocular pressure and one eye enucleated during surgery for supramandibular carcinoma. These eyes were studied with light and electron microscopy.
In the region of parapapillary chorioretinal atrophy of glaucomatous eyes, the retinal pigment epithelial cells showed degenerative changes, such as loss of basal infoldings and microvilli, degenerated mitochondria, vacuolar degeneration and irregular distribution of melanin granules. The photoreceptors were decreased in number in this area of glaucomatous eyes. The lumen of the choriocapillary vessels adjacent to the optic nerve was collapsed.
These results elucidate the fine structures of deep retina and choroid in the region of parapapillary chorioretinal atrophy of glaucomatous eyes, and suggest that the reduced choroidal perfusion might be the pathogenetic mechanism of glaucomatous parapapillary chorioretinal atrophy.
本研究旨在调查继发性闭角型青光眼患者眼中与视乳头旁脉络膜视网膜萎缩相对应的视网膜深层和脉络膜的超微结构。
青光眼患眼包括因虹膜环黑色素瘤伴高眼压而摘除的2只眼，以及因眼痛而摘除的1只新生血管性青光眼患眼。对照眼包括因脉络膜恶性黑色素瘤伴正常眼压而摘除的1只眼，以及1例下颌骨癌手术中摘除的眼。对这些眼睛进行了光镜和电镜研究。
在青光眼患眼的视乳头旁脉络膜视网膜萎缩区域，视网膜色素上皮细胞出现退行性改变，如基底褶皱和微绒毛缺失、线粒体退变、空泡变性以及黑色素颗粒分布不规则。该区域青光眼患眼的光感受器数量减少。视神经附近的脉络膜毛细血管腔塌陷。
这些结果阐明了青光眼患眼视乳头旁脉络膜视网膜萎缩区域视网膜深层和脉络膜的精细结构，并提示脉络膜灌注减少可能是青光眼视乳头旁脉络膜视网膜萎缩的发病机制。
