[Corneal changes in Fuchs endothelial corneal dystrophy and bullous keratopathy].

Q4 Medicine

Arkhiv patologii Pub Date : 2023-01-01 DOI:10.17116/patol20238505129

T A Demura, N V Fisenko, G A Osipyan, M A Afonina

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引用次数: 0

Abstract

Objective: Evaluation of structural and immunohistochemical features of cornea in Fuchs endothelial corneal dystrophy (FECD) and bullous keratopathy (BK).

Material and methods: Group 1 - 44 patients (46 eyes) with FECD, group 2 - 42 patients (42 eyes) with BK. All patients underwent keratoplasty. Preoperative anterior segment optical coherence tomography (AS-OCT, RTVue-100, Optovue, USA) was performed. Endothelium-Descemet membrane (EDM) complexes, corneal buttons were obtained intraoperatively. Morphological (H&E staining) and immunohistochemical (primary antibodies to pancytokeratin, vimentin, fibronectin) studies were performed at the light microscope level (Leica DM-2500, Leica Application Suite V4.8, Leica Microsystems, Switzerland).

Results: A direct correlation is found between the results of DM analysis in vivo with OCT and ex vivo with light microscopy. DM thickness (AS-OCT) was significantly greater in FECD (23.0 [19.0; 27.0] μm), than in BK (13.0 [12.0; 14.0] μm). Morphological study of EDM and corneal buttons showed similar difference in DM thickness: 17.9 [16.1; 20.0] μm in FECD and 11.9 [11.3; 13.0] μm in BK. Irregular optical density of stroma is a feature of edema and local fibrosis. In FECD and BK pancytokeratin is expressed in epithelial and endothelial cells, vimentin - in keratocytes, macrophages and vascular endothelium, fibronectin - in DM. In FECD, vimentin is expressed in endothelial cells.

Conclusion: FECD and BK are associated with different DM' and endothelium' abnormalities, which lead to similar changes of stroma and epithelium. AS-OCT is a useful method of FECD and BK in vivo diagnostics and the selection of treatment option.

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【Fuchs内皮性角膜营养不良和大泡性角膜病变的角膜变化】。

目的：评价Fuchs内皮性角膜营养不良（FECD）和大泡性角膜病（BK）患者角膜的结构和免疫组织化学特征。材料和方法：1-44例（46眼）FECD患者，2-42例（42眼）BK患者。所有患者均行角膜移植术。术前进行了前段光学相干断层扫描（AS-OCT，RTVue-100，Optovue，USA）。术中获得角膜内皮后弹力膜复合体、角膜按钮。在光学显微镜水平（Leica DM-2500，Leica Application Suite V4.8，Leica Microsystems，Switzerland）进行形态学（H&E染色）和免疫组织化学（泛细胞角蛋白、波形蛋白和纤连蛋白的第一抗体）研究。结果：OCT体内DM分析结果与光学显微镜离体DM分析结果之间存在直接相关性。FECD的DM厚度（AS-OCT）（23.0[19.0；27.0]μm）明显大于BK（13.0[12.0；14.0]μm）。EDM和角膜扣的形态学研究显示，DM厚度差异相似：FECD为17.9[16.1；20.0]μm，BK为11.9[11.3；13.0]μm。基质光密度不规则是水肿和局部纤维化的特征。在FECD和BK中，全细胞角蛋白在上皮和内皮细胞中表达，波形蛋白在角膜细胞、巨噬细胞和血管内皮中表达，纤连蛋白在DM中表达。结论：FECD和BK与不同的DM和内皮异常有关，导致基质和上皮发生相似的变化。AS-OCT是FECD和BK体内诊断和治疗选择的有用方法。

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来源期刊

Arkhiv patologii Medicine-Pathology and Forensic Medicine

CiteScore

0.90

自引率

0.00%

发文量

期刊介绍： The journal deals with original investigations on pressing problems of general pathology and pathologic anatomy, newest research methods, major issues of the theory and practice as well as problems of experimental, comparative and geographic pathology. To inform readers latest achievements of Russian and foreign medicine the journal regularly publishes editorial and survey articles, reviews of the most interesting Russian and foreign books on pathologic anatomy, new data on modern methods of investigation (histochemistry, electron microscopy, autoradiography, etc.), about problems of teaching, articles on the history of pathological anatomy development both in Russia and abroad.