角膜水肿Cornea Edema · 眼 · 特殊感觉系统 · NTP ntp-0349

依据美国国家毒理学计划(NTP)Nonneoplastic Lesion Atlas 整理 · 中文译文与诊断建议 · 仅供科研使用,不用于临床诊断

一句话结论:角膜的透明度在一定程度上归因于其相对脱水的正常状态(与其他组织相比)以及有序的基质层板结构。
诊断要点:角膜水肿应当被诊断并赋予严重程度分级。当角膜水肿被认为是炎症的一个特征时,不应单独诊断,除非严重程度足以支持单独诊断,但应在描述中予以叙述。

病变描述

角膜的透明度在一定程度上归因于其相对脱水的正常状态(与其他组织相比)以及有序的基质层板结构。基质液体的增加(水肿)会增加角膜的水合作用并破坏层板排列,从而导致透明度丧失(临床上常描述为角膜“雾状混浊”或“混浊”)。角膜水肿常与炎症(各种病因所致)相关,但也可能由角膜内皮功能障碍引起的渗透性紊乱、角膜缘血管通透性增加以及眼内压变化所致。角膜基质水肿有时难以与人为裂隙和稀疏化相区分。角膜基质水肿(嗜酸性蛋白性液体的积聚)导致角膜整体增厚(Figure 1,与Figure 2中的正常角膜相比较)。水肿的角膜还可能表现为基质胶原层板的排列紊乱和分离、基质新生血管形成以及Descemet膜折叠(Figure 1)。

诊断与分级建议(NTP 共识)

角膜水肿应当被诊断并赋予严重程度分级。当角膜水肿被认为是炎症的一个特征时,不应单独诊断,除非严重程度足以支持单独诊断,但应在描述中予以叙述。

图谱

角膜水肿(眼)组织学图谱 1
图 1 · 角膜水肿 · 来源:NTP NNL Atlas
角膜水肿(眼)组织学图谱 2
图 2 · 角膜水肿 · 来源:NTP NNL Atlas

英文原文

展开 NTP 官方英文描述与建议

Comment:
The transparency of the cornea is to some degree due to its relatively dehydrated normal state (compared with other tissues) and to the orderly stromal lamellar architecture. Increased stromal fluid (edema) increases corneal hydration and disrupts the lamellar arrays, thus resulting in loss of transparency (often described clinically as corneal "haze" or "opacity"). Corneal edema is often associated with inflammation (of various etiologies) but can also result from osmotic derangements due to corneal endothelial malfunction; increased permeability of limbal vessels; and changes in intraocular pressure. Corneal stromal edema can sometimes be difficult to distinguish from artifactual clefts and rarefaction. Corneal stromal edema (accumulation of eosinophilic proteinaceous fluid) results in overall thickening of the cornea ( Figure 1 , compare to normal cornea in Figure 2 ). The edematous cornea may also exhibit disorganization and separation of the stromal collagen lamellae, stromal neovascularization, and Descemet’s membrane folding ( Figure 1 ).

Recommendation:
Corneal edema should be diagnosed and assigned a severity grade. When corneal edema is considered a feature of inflammation, it should not be diagnosed separately, unless warranted by severity, though it should be described in the narrative.

来源与引用

原始条目:https://ntp.niehs.nih.gov/atlas/nnl/special-senses-system/eye/Cornea-Edema

图谱总目录:NTP Nonneoplastic Lesion Atlas。 内容属美国联邦政府作品(公有领域),可引用;引用时请标注来源。

建议引用格式:NTP Nonneoplastic Lesion Atlas. Cornea Edema (eye). LabSmart 中文版: https://www.labsmart.cn/ntp/eye-cornea-edema.html

中文图谱总页(可展开对照全部 595 条):https://www.labsmart.cn/ntp-atlas.html#eye-cornea-edema

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