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中华眼科医学杂志(电子版) ›› 2025, Vol. 15 ›› Issue (06) : 357 -361. doi: 10.3877/cma.j.issn.2095-2007.2025.06.007

病例报告

胺碘酮角膜病变1例
张菊1, 金文4, 史雨荣1, 段文萱2, 高凌寒2, 段艳丽3, 刘洋4,()   
  1. 11730000 兰州大学第一临床医学院 2023级硕士研究生
    21730000 兰州大学第一临床医学院 2024级硕士研究生
    31730000 兰州大学第一临床医学院 2025级硕士研究生
    42730000 兰州大学第一临床医学院 兰州大学第一医院眼科
  • 收稿日期:2025-11-04 出版日期:2025-12-28
  • 通信作者: 刘洋
  • 基金资助:
    国家自然科学基金地区基金项目(82260201); 甘肃省自然科学基金项目(22JR5RA917); 甘肃省卫生健康委员会行业管理项目(GSWSKY-2019-93); 兰州大学第一医院优秀博士启动基金项目(ldyyyn2018-22)

One case of amiodarone induced keratopathy

Ju Zhang, Wen Jin, Yurong Shi   

  • Received:2025-11-04 Published:2025-12-28
引用本文:

张菊, 金文, 史雨荣, 段文萱, 高凌寒, 段艳丽, 刘洋. 胺碘酮角膜病变1例[J/OL]. 中华眼科医学杂志(电子版), 2025, 15(06): 357-361.

Ju Zhang, Wen Jin, Yurong Shi. One case of amiodarone induced keratopathy[J/OL]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2025, 15(06): 357-361.

图3 患者左眼胺碘酮角膜病变患者治疗前后共聚焦显微镜显微照像 图3A~3F示治疗前角膜上皮层大量高反射颗粒沉积,细胞边界不清(图3A橙色箭头所示);上皮下神经丛被颗粒部分遮蔽(图3B红色星形所示);浅基质内基质细胞活化(图3C紫色箭头所示),胞浆内和胞浆间有较多点状高反射颗粒沉积(图3C橙色箭头所示);浅层角膜基质细胞活化,胞浆内高反射、致密颗粒沉积呈块状(图3D紫色箭头所示);部分深层角膜基质细胞胞浆反射增强、活化(图3E紫色箭头所示);部分角膜内皮细胞面积增大,异型性增强(图3F紫色箭头所示)。图3G~3L示治疗后角膜上皮细胞内高反射颗粒显著减少(图3G橙色箭头所示);上皮下神经丛周围仍可见较多高反射颗粒分布(图3H红色星形所示),神经纤维神经瘤形成(图3H蓝色箭头所示);部分神经粗大、呈颗粒状高反射(图3I,蓝色箭头所示);浅层角膜基质细胞仍处于活化状态(图3J,紫色箭头所示),少量细胞胞浆内高反光颗粒沉积呈簇状(图3J,橙色箭头所示);深层神经纤维走形扭曲(图3K蓝色箭头所示),局部神经瘤形成(图3K绿色箭头所示);部分角膜内皮细胞面积扩大、异型性增强(图3L紫色箭头所示)(×800)
[1]
Sorodoc V, Indrei L, Dobroghii C, et al. Amiodarone therapy: Updated practical insights[J]. Journal of Clinical Medicine, 2024, 13(20): 6094.
[2]
Kowey PR, Marinchak RA, Rials SJ, et al. Intravenous amiodarone[J]. Journal of the American College of Cardiology, 1997, 29(6): 1190-1198.
[3]
Mujoviĉ N, Dobrev D, Marinkoviĉ M, et al. The role of amiodarone in contemporary management of complex cardiac arrhythmias[J]. Pharmacological Research, 2020, 151: 104521.
[4]
Latini R, Tognoni G, Kates RE. Clinical pharmacokinetics of amiodarone[J]. Clinical pharmacokinetics, 1984, 9(2): 136-156.
[5]
Saigal K, Sussmane S, Tuli S. Corneal Amiodarone Deposition and Its Implications for Autologous Serum Eye Drop Therapy: A Case Report[J]. Cureus, 2025, 17(11): e96670..
[6]
Martin WJ, Kachel DL, Vilen T, et al. Mechanism of phospholipidosis in amiodarone pulmonary toxicity[J]. The Journal of pharmacology and experimental therapeutics, 1989, 251(1): 272-278.
[7]
Yoon JJ, Ismail S, Sherwin T. Limbal stem cells: Central concepts of corneal epithelial homeostasis[J]. World journal of stem cells, 2014, 6(4): 391.
[8]
Dua HS, Watson NJ, Mathur RM, et al. Corneal epithelial cell migration in humans:'hurricane and blizzard keratopathy'[J]. Eye, 1993, 7(1): 53-58.
[9]
Dua HS, Singh A, Gomes JAP, et al. Vortex or whorl formation of cultured human corneal epithelial cells induced by magnetic fields[J]. Eye, 1996, 10(4): 447-450.
[10]
Kaplan LJ, Cappaert WE. Amiodarone-induced corneal deposits[J]. Annals of ophthalmology, 1984, 16(8): 762-766.
[11]
Ikegawa Y, Shiraishi A, Hayashi Y, et al. In Vivo Confocal Microscopic Observations of Vortex Keratopathy in Patients with Amiodarone-Induced Keratopathy and Fabry Disease[J]. Journal of Ophthalmology, 2018: 5315137.
[12]
D'Amico DJ, Kenyon KR, Ruskin JN. Amiodarone keratopathy: drug-induced lipid storage disease[J]. Archives of Ophthalmology, 1981, 99(2): 257-261.
[13]
Orlando RG, Dangel ME, Schaal SF. Clinical experience and grading of amiodarone keratopathy[J]. Ophthalmology, 1984, 91(10): 1184-1187.
[14]
Nielsen CE, Andreasen F, Bjerregaard P. Amiodarone induced cornea verticillata[J]. Acta Ophthalmologica, 1983, 61(3): 474-480.
[15]
Ciancaglini M, Carpineto P, Zuppardi E, et al. In vivo confocal microscopy of patients with amiodarone-induced keratopathy[J]. Cornea, 2001, 20(4): 368-373.
[16]
Victor G, Alves MR, Nosé W. In vivo confocal microscopy in amiodarone corneal deposits[J]. Arquivos Brasileiros de Oftalmologia, 2007, 70: 45-50.
[17]
Inoue H, Toriyama K, Joko T, et al. In vivo confocal microscopic images of atypical amiodarone-induced keratopathy in patient with epithelial basement membrane dystrophy[J]. American journal of ophthalmology case reports, 2021, 22: 101105.
[18]
Uĉakhan ÖÖKanpolat A, Ylmaz N, et al. Amiodarone keratopathy: an in vivo confocal microscopy study[J]. Eye & contact lens, 2005, 31(4): 148-157.
[19]
Andres J. Ophthalmic Toxicities of Systemic Drug Therapy[J]. US Pharm, 2015, 6: 23.
[20]
胡茂生,王秀英. 乙胺碘呋酮引起角膜色素沉着(30例临床观察)[J]. 眼科研究19834(2):116-117.
[21]
Alshehri M, Joury A. Ocular adverse effects of amiodarone: a systematic review of case reports[J]. Optometry and Vision Science, 2020, 97(7): 536-542.
[22]
Mehta S, Bunya VY, Orlin SE, et al. A significant drug-drug interaction detected through corneal examination: resolution of cornea verticillata while using amiodarone[J]. Cornea, 2012, 31(1): 81-83.
[23]
Schiffmann R, Fuller M, Clarke LA, et al. Is it Fabry disease?[J]. Genetics in Medicine, 2016, 18(12): 1181-1185.
[24]
Schiffmann R. Fabry disease[J]. Pharmacology & therapeutics, 2009, 122(1): 65-77.
[25]
Zhou X, Li Y, Zhao Y, et al. Corneal neuro-immune crosstalk in Fabry disease: An in vivo confocal microscopic study[J]. Journal of Neuroimmunology, 2025: 578759.
[26]
Mastropasqua L, Nubile M, Lanzini M, et al. Corneal and conjunctival manifestations in Fabry disease: in vivo confocal microscopy study[J]. American journal of ophthalmology, 2006, 141(4): 709-709.
[27]
Yamagiwa Y, Haranosono Y, Nemoto S, et al. Characteristics of corneal phospholipidosis induced by topical ocular application of chloroquine and amiodarone in rabbits[J]. Journal of Toxicologic Pathology, 2017, 30(2): 135-143.
[28]
Ma X, He L, He D, et al. Chloroquine keratopathy of rheumatoid arthritis patients detected by in vivo confocal microscopy[J]. Current Eye Research, 2012, 37(4): 293-299.
[29]
Paulose RM, Chhablani J, Jhingan M. Update on hydroxychloroquine retinopathy[J]. Kerala Journal of Ophthalmology, 2017, 29(1): 9-13.
[30]
Paladini I, Menchini U, Mencucci R. In vivo confocal microscopy in chloroquine-induced keratopathy[J]. Middle East African Journal of Ophthalmology, 2013, 20(1): 77-79.
[31]
Ma X, He L, He D, et al. Chloroquine keratopathy of rheumatoid arthritis patients detected by in vivo confocal microscopy[J]. Current Eye Research, 2012, 37(4): 293-299.
[32]
Sams WM. Chloroquine: mechanism of action[J]. Mayo Clinic Proceedings. Elsevier, 1967, 42(5): 300-309.
[33]
Tomatsu S, Pitz S, Hampel U. Ophthalmological findings in mucopolysaccharidoses[J]. Journal of clinical medicine, 2019, 8(9): 1467.
[34]
Williams IM, Pineda R, Neerukonda VK, et al. Mucopolysaccharidosis Type I-Associated Corneal Disease: A Clinicopathologic Study[J]. American Journal of Ophthalmology, 2021, 231: 39-47.
[35]
Nagueh SF. Anderson-Fabry disease and other lysosomal storage disorders[J]. Circulation, 2014, 130(13): 1081-1090.
[36]
Matoba A, Oie Y, Tanibuchi H, et al. Anterior segment optical coherence tomography and in vivo confocal microscopy in cases of mucopolysaccharidosis[J]. American Journal of Ophthalmology Case Reports, 2020, 19: 100728.
[37]
Alroy J, Haskins M, Birk DE. Altered corneal stromal matrix organization is associated with mucopolysaccharidosis I, III and VI[J]. Experimental eye research, 1999, 68(5): 523-530.
[38]
Del Longo A, Piozzi E, Schweizer F. Ocular features in mucopolysaccharidosis: diagnosis and treatment[J]. Italian journal of pediatrics, 2018, 44(Suppl 2): 125.
[39]
Maisuria NG, Shah K, Das M, et al. Ocular Toxicity Of Phenothiazine[J]. Haryana Journal Of Ophthalmology, 2022, 14(2): 60-62.
[40]
Pouget R, Blayac JP, Largey B, et al. Corneal and lens deposits due to treatment by phenothiazine type neuroleptics[J]. Annales Médico-Psychologiques. 1976, 1(3): 403-407.
[41]
Razeghinejad MR, Nowroozzadeh MH, Zamani M, et al. In vivo observations of chlorpromazine ocular deposits in a patient on long-term chlorpromazine therapy[J]. Clinical & Experimental Ophthalmology, 2008, 36(6): 560-563.
[42]
Raizman MB, Hamrah P, Holland EJ, et al. Drug-induced corneal epithelial changes[J]. Survey of ophthalmology, 2017, 62(3): 286-301.
[43]
Kaštelan S, Gabriĉ K, Mikuliĉiĉ M, et al. The influence of tear film quality on visual function[J]. Vision, 2024, 8(1): 8.
[44]
Wu H, Lin Z, Yang F, et al. Meibomian gland dysfunction correlates to the tear film instability and ocular discomfort in patients with pterygium[J]. Scientific reports, 2017, 7(1): 45115.
[45]
Wei Z, Su Y, Su G, et al. Effect of artificial tears on dynamic optical quality in patients with dry eye disease[J]. BMC ophthalmology, 2022, 22(1): 64.
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