# 玻璃体纤维化（Vitreous Fibrosis）

- 器官 / 系统：眼 / 特殊感觉系统（eye / special-senses-system）
- NTP 数据编号：ntp-0332
- 规范 URL：https://www.labsmart.cn/ntp/eye-vitreous-fibrosis.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#eye-vitreous-fibrosis
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/special-senses-system/eye/Vitreous-Fibrosis
- 授权：美国联邦政府作品，公有领域；引用请标注 NTP Nonneoplastic Lesion Atlas
- 适用说明：仅供科研使用，不用于临床诊断

## 一句话结论
玻璃体的各种损伤（穿透性损伤、炎症等）可导致反应性血管化和机化，并伴有玻璃体纤维结缔组织增生（玻璃体瘢痕或纤维膜形成）。

## 病变描述（中文）
玻璃体的各种损伤（穿透性损伤、炎症等）可导致反应性血管化和机化，并伴有玻璃体纤维结缔组织增生（玻璃体瘢痕或纤维膜形成）。在早期纤维化中，疏松的纤维结缔组织填充晶状体与视网膜之间的玻璃体空间（Figure 1、Figure 2）。更进展的纤维化（Figure 3、Figure 4）以致密的成熟纤维组织层为特征，取代正常玻璃体。玻璃体纤维化常伴有慢性炎症和/或色素性巨噬细胞聚集（Figure 1、Figure 2、Figure 3、Figure 4）。反应性视网膜色素上皮（retinal pigment epithelium，RPE）细胞可经视网膜迁移进入玻璃体（Figure 5），并沿视网膜内表面蔓延。此类迁移的 RPE 细胞可发生纤维性化生（上皮-间充质转化）而转变为成纤维细胞样细胞，并参与异常玻璃体纤维组织的形成，包括视网膜表面及其他眼后段结构上的纤维膜。参与玻璃体纤维化发生的其他细胞包括活化的常驻玻璃体透明细胞、视网膜 Müller 细胞和星形胶质细胞、移入的巨噬细胞以及巩膜成纤维细胞。晚期玻璃体纤维化中偶尔可形成软骨性或骨性化生（Figure 6）。

## 诊断与分级建议（NTP 共识，中文）
玻璃体纤维化应作出诊断并赋予严重程度分级。若与描述治疗相关效应有关，应在文字描述中描述纤维组织的形态和分布（例如视网膜前膜）。病理学家应自行判断在特定动物中是仅诊断玻璃体炎症还是玻璃体纤维化，抑或两者均诊断。RPE 细胞迁移以及软骨性和骨性化生等特征不应单独诊断，但可在病理学文字描述中加以描述。

## 英文原文 · Comment
Various insults to the vitreous (penetrating injury, inflammation, etc.) can result in reactive vascularization and organization with proliferation of vitreal fibrous connective tissue (vitreal scar or fibrous membrane formation). In early fibrosis, loose fibrous connective tissue fills the vitreous space ( Figure 1 and Figure 2 ) between the lens and retina. More advanced fibrosis ( Figure 3 and Figure 4 ) is characterized by dense sheets of mature fibrous tissue that replace the normal vitreous. Vitreous fibrosis is often associated with chronic inflammation and/or pigmented macrophage accumulations ( Figure 1 , Figure 2 , Figure 3 , and Figure 4 ). Reactive retinal pigment epithelium (RPE) cells may migrate transretinally into the vitreous ( Figure 5 ) and spreading along the inner surface of the retina. Such migrant RPE cells can undergo fibrous metaplasia (epithelial-to-mesenchymal transition) into fibroblast-like cells and participate in the formation of abnormal vitreal fibrous tissue, including fibrous membranes on the surface of the retina and other posterior ocular structures. Other cells that participate in development of vitreal fibrosis include activated resident vitreal hyalocytes, retinal Müller cells and astrocytes, immigrant macrophages, and scleral fibroblasts. Cartilaginous or osseous metaplasia can occasionally form in late-stage vitreal fibrosis ( Figure 6 ).

## 英文原文 · Recommendation
Vitreous fibrosis should be diagnosed and assigned a severity grade. If pertinent to the characterization of a treatment-related effect, the morphology and distribution of the fibrous tissue (e.g., epiretinal membranes) should be described in the narrative. The pathologist should exercise judgment in deciding whether to diagnose only vitreal inflammation or vitreal fibrosis in a given animal, or whether to diagnose both. Features such as RPE cell migration and cartilaginous and osseous metaplasia should not be diagnosed separately, though they can be described in the pathology narrative.

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_1018.jpg
- https://www.labsmart.cn/ntp-atlas-images/ntp_1015.jpg

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