原发性色素播散综合征中房水黑色素颗粒的定量分析

Quantification of aqueous melanin granules in primary pigment dispersion syndrome.

作者信息

Küchle M, Mardin C Y, Nguyen N X, Martus P, Naumann G O

机构信息

Department of Ophthalmology and University Eye Hospital, University of Erlangen-Nürnberg, Erlangen, Germany.

出版信息

Am J Ophthalmol. 1998 Sep;126(3):425-31. doi: 10.1016/s0002-9394(98)00098-1.

DOI:10.1016/s0002-9394(98)00098-1

PMID:9744376

Abstract

PURPOSE

Aqueous melanin granules are essential in the pathogenesis of pigment dispersion syndrome and pigmentary glaucoma. We quantified aqueous melanin granules with the laser flare-cell meter in patients with pigment dispersion syndrome, assessed the measurement reproducibility, and correlated the numbers with clinical findings.

METHODS

Aqueous melanin granules were counted by means of the cell count mode of the laser flare-cell meter (KOWA FC-1000; Kowa, Tokyo, Japan) in 42 eyes of 21 patients with primary pigment dispersion syndrome under three conditions (undilated pupils, dilated pupils, after exercise). The reproducibility of the measurements was determined with the intraclass correlation coefficient. A control group of 40 age- and sex-matched eyes was also examined after pupillary dilation. The results were correlated with biomicroscopic findings in eyes with pigment dispersion syndrome (retrocorneal Krukenberg spindle, iris transillumination, pigmentation of trabecular meshwork).

RESULTS

Numerous aqueous melanin granules were detected in eyes with pigment dispersion syndrome (mean, 2.9 +/- 3.7 granules/0.075 mm3) but only small numbers were counted in normal eyes (0.2 +/- 0.3, P < .001). Medical pupil dilation caused an additional increase of aqueous melanin granules in pigment dispersion syndrome (6.3 +/- 5.3, P < .001), but not undilated exercise (climbing stairs) (2.9 +/- 3.7, P > .5). The reproducibility of the measurements was very high (intraclass coefficient >0.92). The number of melanin granules correlated with the degree of Krukenberg spindle (r = .61, P = .004) and with iris transillumination (r = .69, P = .001).

CONCLUSIONS

Quantification of aqueous melanin granules yields reproducible results and shows increased numbers in pigment dispersion syndrome, especially after pupillary dilation. Aqueous melanin granule quantification may be useful for evaluating eyes with pigment dispersion syndrome and for assessing treatment effects.

摘要

目的

房水黑色素颗粒在色素播散综合征和色素性青光眼的发病机制中至关重要。我们使用激光散射细胞仪对色素播散综合征患者的房水黑色素颗粒进行定量，评估测量的可重复性，并将颗粒数量与临床发现进行关联。

方法

使用激光散射细胞仪（KOWA FC - 1000；日本东京Kowa公司）的细胞计数模式，在三种情况下（瞳孔未散大、瞳孔散大、运动后）对21例原发性色素播散综合征患者的42只眼睛中的房水黑色素颗粒进行计数。测量的可重复性通过组内相关系数确定。还对40只年龄和性别匹配的瞳孔散大后的眼睛组成的对照组进行了检查。结果与色素播散综合征眼睛的生物显微镜检查结果（角膜后克鲁肯伯格梭、虹膜透照、小梁网色素沉着）相关。

结果

在色素播散综合征的眼睛中检测到大量房水黑色素颗粒（平均2.9±3.7颗粒/0.075 mm³），而在正常眼睛中仅计数到少量颗粒（0.2±0.3，P <.001）。药物性瞳孔散大导致色素播散综合征中房水黑色素颗粒进一步增加（6.3±5.3，P <.001），但未散大时运动（爬楼梯）则没有（2.9±3.7，P>.5）。测量的可重复性非常高（组内系数>0.92）。黑色素颗粒的数量与克鲁肯伯格梭的程度（r =.61，P =.004）和虹膜透照（r =.69，P =.001）相关。