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THE MORPHOLOGICAL FINDINGS OF AMIODARONE INDUCED CORNEAL VERTICILLATA UNDER IN VIVO CONFOCAL MICROSCOPY: A CASE REPORT
Amiodarone造成之輪狀角膜病變在共軛焦顯微鏡下之表現
摘要
目的；報告使用共軛焦顯微鏡檢查Amiodarone造成之輪狀角膜病變的特徵及細胞變化。方法；病例報告。結果:一位71歲男性，長期服用amiodarone控制心房顫動有兩年之久，最近半年雙眼視力模糊至本院眼科就醫，眼科檢查發現雙眼角膜輪狀沉積物，診斷為Amiodarone造成之輪狀角膜病變，安排共軛焦顯微鏡檢查，發現高反光沉積物在角膜表皮，基底層，前端基質層。結論；共軛焦顯微鏡檢查Amiodarone造成之輪狀角膜病變，能夠顯示角膜細胞的細節。Amiodarone不只在全層角膜造成沉積物，也使得角膜神經產生型態變異，需要長期研究釐清amiodarone對角膜及神經的毒性。
關鍵字
無資料並列摘要
Purpose: To report a case of amiodarone-induced corneal verticillata and evaluate the characteristics and corneal morphological changes using in vivo laser scanning confocal microscopy. Method: A case report. Result: A 71-year-old male with atrial fibrillation who was treated with amiodarone for 2 years presented with progressive blurred vision in both eyes for 6 months. Ophthalmological examinations revealed a bilateral whorl-like pattern of symmetric golden brown deposits on the inferior portion of the cornea. Amiodarone-induced corneal verticillata was diagnosed. In vivo laser scanning confocal microscopy revealed hyper-reflective basal laminar depositions in both eyes. These deposits were also observed in the anterior stromal layer. Conclusion: Amiodarone keratopathy resulted in not only hyper-reflective deposits involving all corneal layers but also morphological abnormalities in the subepithelial nerve fibers. Further long-term studies are warranted to clarify the toxicity of amiodarone to the cornea and subepithelial nerve fibers.