Sequential corneal infection with two genotypically distinct Acanthamoebae associated with renewed contact lens wear.
Sequential corneal infection with two genotypically distinct Acanthamoebae associated with renewed contact lens wear.
复制标题
两种基因型不同的棘阿米巴引起的连续角膜感染与重新佩戴隐形眼镜有关。
DOI：
10.1038/eye.2009.288
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Fuerst,PE
中科院分区：
文献类型：
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作者：
Tu,EY;Joslin,CE;Shoff,ME;Lee,JA;Fuerst,PE
这篇由Charbel Issa等人撰写的文章是关于2型特发性黄斑毛细血管扩张(IMT)与全层黄斑裂孔(MHS)和板层黄斑裂孔(MHS)的关系的有趣报告。IMT的病因尚不清楚，但可能包括高通透性毛细血管的慢性渗漏和缺血。作者假设，IMT中的MHS是由这些因素导致的组织丢失引起的，继发于这些区域的未确定的膜，可能是ILM，而不是公认的导致特发性MHS的视网膜前牵引力的概念。我们描述了一例IMT合并ERM的病例，通过玻璃体切割术显示视力改善，这与IMT的病因和向MH的演变有关。一位66岁的人工晶状体眼女性，有3年的中央视力逐渐下降的病史。基础镜下她有典型的IMT征象，血管造影证实了这一点。此外，她的双眼都有很好的表面ERM，左眼更差。对左眼进行玻璃体切除，分离未完全附着的后部玻璃体表面并剥离ERM。术后视力从6/36提高到6/12。鉴于左眼视力的改善，对右眼也进行了类似的手术。再一次，视力从6/60提高到6/18。随访3年后，她的视力保持稳定。在一些慢性视网膜血管渗漏和缺氧的情况下可以看到ERM的形成，最明显的是糖尿病黄斑病变。在这些情况下，ERM的形成可能部分是由低氧细胞因子驱动的组织修复推动的。2-4可能在IMT中，这在导致ERM的有害修复过程中也起着重要作用，在某些情况下，还会导致牵引。玻璃体切除术增加了玻璃体腔内的氧气，增加了视网膜的氧气供应，从而潜在地抑制了组织修复过程，并改善了视网膜功能。5.
The article by Charbel Issa et al1 is an interesting report on the association of type 2 idiopathic macular telangiectasia (IMT) with both full-thickness and lamellar macular holes (MHs). The aetiology of IMT is unknown, but possibilities include chronic leakage from hyperpermeable capillaries and ischaemia. The authors hypothesise that MHs in IMT are caused by tissue loss consequential to these factors, with secondary draping of an as yet undefined membrane, possibly ILM, over these areas rather than the accepted concept of epiretinal tractional forces that result in idiopathic MHs. We describe a case of IMT with ERM that showed visual improvement with vitrectomy, which is relevant to the aetiology of IMT and the evolution to a MH. A 66-year-old pseudophakic woman presented with a 3-year history of gradually reducing central vision. Fundoscopically she had the typical signs of IMT, which were confirmed on angiography. In addition, she had very fine surface ERM in both eyes, which was worse in the left eye. Vitrectomy was carried out on the left eye, with separation of an incompletely attached posterior hyaloid face and peeling of the ERM. Postoperatively her vision improved from 6/36 to 6/12. In view of the improvement in the left eye, a similar surgery was carried out on the right eye. Once again, visual acuity improved from 6/60 to 6/18. Her vision remained stable at follow-up 3 years later.ERM formation can be seen in a number of situations in which chronic retinal vascular leakage and hypoxia occur, most notably in diabetic maculopathy. ERM formation in these situations is likely to be driven partly by hypoxic cytokine-driven tissue repair. 2–4 Perhaps in IMT, this also has a significant role in leading to a detrimental repair process causing ERM, and in some cases, traction. Vitrectomy increases oxygenation in the vitreous cavity, increasing the availability of oxygen to the retina and thus potentially dampening tissue repair processes, as well as improving retinal function. 5