交感性眼炎的临床与免疫组化分析

Clinical and immunohistochemical studies on sympathetic ophthalmia

通过对因交感性眼炎而摘除的眼球进行病理及免疫组化分析 ,结合临床特征 ,探讨交感性眼炎的发病机理。方法 :17例诊断为交感性眼炎行交感眼眼球摘除的病人 ,眼球标本用HE染色 ,观察炎症细胞在脉络膜、巩膜血管及神经周围的分布及细胞种类。其中 10例进行免疫组化染色 ,用CD3、CD45RO标记T淋巴细胞 ,CD2 0标记B淋巴细胞 ,CD6 8标记巨噬细胞。观察这些抗体在脉络膜、巩膜血管及神经、结膜下血管的分布特点及强度。结果 :HE染色 :淋巴细胞浸润在脉络膜大中血管层及脉络膜上腔 ,间有上皮样及多核巨细胞。巩膜内血管及神经亦可见淋巴细胞浸润。免疫组化 :CD3、CD45RO阳性细胞分布在脉络膜、巩膜、结膜下组织中 ,多在上皮样细胞、巩膜静脉及神经、结膜下血管周围。CD2 0主要分布在脉络膜上腔及外层脉络膜。CD6 8阳性细胞主要分布在脉络膜上皮样细胞、多核巨细胞及巩膜及结膜下血管周围。结论 :交感性眼炎是一种非环死肉芽肿性葡萄膜炎 ,炎症不仅局限于脉络膜 ,亦可见于巩膜和结膜下。巩膜的血管及神经周围存在吞噬色素的上皮样细胞 ,提示交感性眼炎的发生与色素颗粒或其他相关抗原密切相关。

Objective:To investigate the clinical pathology and the infiltrating cell phenotypes of sympathetic ophthalmia. Methods:17 enucleated eyes,diagnosed as sympathetic ophthalmia,were studied.All 17 cases were stained with HE.10 of 17 cases were run immunohistochemical stain with anti CD3,CD45RO (T-lymphocytes marker),CD20 (B-lymphocytes marker) and CD68 (macrophage marker) antibodies. Results:HE staining:choroid was diffusely infiltrated with large amount of lymphocytes,some epithelioidal cells and giant cells.Immunohistochemically,CD45RO positive cells were located in the inner choroid and sclera;CD20 positive cells in the outer choroid,a few in the sclera;CD68 mainly stained epithelioidal and giant cells. Conclusions:the results indicated that the uveal pigment or related protein antigens might play an important rule in the pathogenesis of sympathetic ophthalmia