Kennedy C J
Lions Eye Institute, Centre for Ophthalmology and Visual Science, Nedlands, Western Australia.
Aust N Z J Ophthalmol. 1996 Aug;24(3):267-73. doi: 10.1111/j.1442-9071.1996.tb01591.x.
Polychromatic cholesterol crystal of the anterior chamber are an interesting and unusual finding. This paper examines the different pathogenetic mechanisms leading to the formation of these clinically detectable anterior chamber crystals.
Three aetiologically different cases which exhibited polychromatic crystals in the anterior chamber were reviewed. Aqueous samples were examined by wet field microscopy in all cases and additionally by electron microscopy in one of these. One enucleated globe was available for histopathology.
Typical highly refringent cholesterol crystals were identified in the aqueous of all cases. In the first case, the cholesterol crystals developed following the breakdown of vitreous and anterior chamber haemorrhage. In the second case, the cholesterol appeared to derive from the subretinal fluid of a chronic total retinal detachment in the absence of any intraocular haemorrhage. The cholesterol crystals of the final case resulted from phacolysis and were associated with a marked neutrophil response and the presence of proteinaceous crystals consistent with the crystallins.
Anterior chamber cholesterolosis is a secondary phenomenon that always occurs as a result of an ocular disease process. Although the prognosis is dismal for chronically diseased eyes displaying cholesterol crystals in the anterior chamber, the prognosis for eyes with phacolysis may be excellent.
前房内的多色胆固醇晶体是一种有趣且不常见的发现。本文探讨导致这些临床上可检测到的前房晶体形成的不同发病机制。
回顾了三例病因不同但前房出现多色晶体的病例。所有病例均通过湿场显微镜检查房水样本，其中一例还进行了电子显微镜检查。有一个摘除的眼球可用于组织病理学检查。
所有病例的房水中均鉴定出典型的高折射胆固醇晶体。在第一例中，胆固醇晶体在玻璃体分解和前房出血后形成。在第二例中，胆固醇似乎来源于慢性完全性视网膜脱离的视网膜下液，且无任何眼内出血。最后一例的胆固醇晶体是晶状体溶解性分解所致，伴有明显的中性粒细胞反应以及与晶状体蛋白一致的蛋白质晶体。
前房胆固醇沉着症是一种继发现象，总是由眼部疾病过程引起。尽管对于前房出现胆固醇晶体的慢性患病眼预后不佳，但晶状体溶解性分解所致的眼预后可能良好。
