角膜内皮炎

Endotheliitis

目的 探讨角膜内皮炎的发病原因 ,证实角膜内皮细胞的改变 ,阐述角膜内皮炎的临床表现特征。方法 ①用多聚酶链反应检测患眼房水中的单纯疱疹病毒DNA ;用间接免疫荧光法检测患眼房水细胞中和小梁组织中的单纯疱疹病毒抗体。②用角膜内皮镜检查患眼愈后角膜内皮细胞密度和形态改变。结果 多聚酶链反应检测 2 0只眼房水 ,单纯疱疹病毒阳性率为 6 0 0 %。间接免疫荧光法检测 14只眼房水涂片 ,荧光抗体阳性率为 2 8 6 % ;1只眼的小梁组织切片检测荧光抗体亦呈阳性。角膜内皮镜检查 10只患眼 ,表明内皮细胞密度降低 ,细胞异形性比率增高。结论 单纯疱疹病毒是角膜内皮炎的主要感染原。感染的主要部位在角膜内皮细胞 ,也可同时感染虹膜睫状体和小梁网。该病特有的临床表现有别其他眼病。

Objective To explore the etiology of corneal endotheliitis and the alteration of endothelial cell.The clinical characteristics of endotheliitis were discussed.Methods ① Herpes simplex virus(HSV) DNA in aqueous humors of the patients with corneal endotheliitis were detected by polymerase chain reaction(PCR).HSV antibodys in aqueous humors and trabecular meshwork of one patient were respectively detected by indirect immunofluorescence.② Endothelial cell density and morphologic changes were observed by specular microscope after endotheliitis were cured.Results The positive rate for HSV DNA in 20 aqueous humors by PCR were 60.0%.The positive rate for HSV Abs in 14 aqueous smears were 28.6% and one trabecular meshwork section was positive by indirect immunofluoreseence.Endothelial cell density decreased and heteromorphic endothelial cell increased of 10 eyes by specular microscope.Conclusions Endotheliitis were mainly infected by HSV.The main site of infection were endothelial cell.Iris ciliary body and trabecular meshwork could be also infected.The clinical characteristics of endotheliitis were special and different from other diseases.