敬請指教

本人才疏學淺,懇請諸位先進前輩不吝指正。歡迎光臨:空中視力保健室

2010年8月12日 星期四

Lens-associated uveitis/glaucoma

Phacolytic glaucoma

* Hypermature cataract,自己leakage (通常在年紀大者)
* 眼壓會急速增高!結膜很紅,角膜很霧
* 與scavenging macrophage堵住TM有關
=> open-angle,trabecular occlusion by macrophage
=> 沒有KP,也沒有synechiae ~考!
* 機轉: innate immunity(aqueous可見lipid-laden macrophage)




Phacoanaphylactic endophthalmitis (phacotoxic, phacoanaphylactic)
* 較為少見
* granulomatous inflammation → 會有KP! (phacolytic者不會有KP)
* 通常是在traumacataract手術後產生
* 機轉:acquired immunity
=> IgG直接攻擊lens protein (immune complex against lens crystallin)
* 眼壓增高
=> open-angle-trabecular occlusion by lens protein
* 雖然名字有 anaphylatic,但卻不是type 1 hypersensitivity (名字取得不好,易誤會)
=> 反而是 type 2,3,4 hypersensitivity參與機轉。




lens particle glaucoma

cataract extraction殘留cortex,造成發炎及blockage of TM by lens protein。




Phacomorphic glaucoma

lens膨大往前頂,Posterior Pushing mechanism→pupillary block→angle closure glaucoma



ectopic lentis

也會造成angle closure glaucoma with pupillary block




例題:

下列何者主要為angle closure glaucoma ?
A. Phacoanaphylactic endophthalmitis
B. Phacolytic glaucoma
C. Phacomorphic glaucoma
D. Lens particle glaucoma

答: C

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