Immunohistochemistry and Electron Microscopy of Retrocorneal Scrolls in Syphilitic Interstitial Keratitis

Doğru, Murat; Kato, Naoko; Matsumoto, Yukihiro; Tanaka, Yoïchi; Akabane, Naoko; Shimmura, Shigeto; Tsubota, Kazuo; Shimazaki, Jun

doi:10.1080/02713680701624705

Cited by 18 publications

(23 citation statements)

References 11 publications

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“…However, RCMs also expressed several corneal endothelium marker including VEGF and VEGFR1. This partial expression pattern of corneal endothelial markers suggests the possible involvement of both of endothelial mesenchymal transition in RCM pathogenesis as previously reported (1, 14) and progenitor cell recruitment from other sites as a new concept of pathogenesis of RCM. This finding is supportive of the argument that RCMs do not originate from corneal endothelia.…”

Section: Discussionsupporting

confidence: 82%

“…Many studies have been conducted to identify the pathogenesis of RCMs (1, 2, 3, 4, 5, 6); however, the results have been largely inconclusive. These past studies have suggested that RCMs are connected to damaged portions of Descemet's membrane and that RCMs grow from the corneal endothelium into the anterior chamber (4, 5, 12, 13, 14, 15). However, these hypotheses are based on the prerequisite that damaged corneas have functional keratocytes and endothelia.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have found that type IV collagen was expressed in RCMs in syphilitic RCMs, which led the investigators to suggest that the endothelium may possibly be transformed into mesenchymal cells (1, 14). However, some researchers have asserted that type IV collagen antibodies do not react with all RCMs (4).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Stem Cell Components in Retrocorneal Membranes

Lee

Kim

et al. 2014

J Korean Med Sci

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The purpose of this study was to elucidate the origin and cellular composition of retrocorneal membranes (RCMs) associated with chemical burns using immunohistochemical staining for primitive cell markers. Six cases of RCMs were collected during penetrating keratoplasty. We examined RCMs with hematoxylin and eosin (H&E), periodic acid-Schiff (PAS) staining and immunohistochemical analysis using monoclonal antibodies against hematopoietic stem cells (CD34, CD133, c-kit), mesenchymal stem cells (beta-1-integrin, TGF-β, vimentin, hSTRO-1), fibroblasts (FGF-β, α-smooth muscle actin), and corneal endothelial cells (type IV collagen, CD133, VEGF, VEGFR1). Histologic analysis of RCMs revealed an organized assembly of spindle-shaped cells, pigment-laden cells, and thin collagenous matrix structures. RCMs were positive for markers of mesenchymal stem cells including beta-1-integrin, TGF-β, vimentin, and hSTRO-1. Fibroblast markers were also positive, including FGF-β and α-smooth muscle actin (SMA). In contrast, immunohistochemical staining was negative for hematopoietic stem cell markers including CD34, CD133 and c-kit as well as corneal endothelial cell markers such as type IV collagen, CD133 except VEGF and VEGFR1. Pigment-laden cells did not stain with any antibodies. The results of this study suggest that RCMs consist of a thin collagen matrix and fibroblast-like cells and may be a possible neogenetic structure produced from a lineage of bone marrow-derived mesenchymal stem cells.Graphical Abstract

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Evaluation of Stem Cell Components in Retrocorneal Membranes

Lee

Kim

et al. 2014

J Korean Med Sci

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“…The duplication phenomenon is rarely seen in the human eye, although less organized multilayering or formation of new basement membrane is well known. 9,10,19,27,31,34,38 The phenomenon of duplication of DM in the COPLOW database has a moderate frequency. It is seen in cats but not in horses or birds.…”

Section: Discussionmentioning

confidence: 99%

Canine Duplication of Descemet's Membrane

Kafarnik

Murphy

Dubielzig³

2009

Vet Pathol

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Abstract. The morphology of a duplication phenomenon of the canine Descemet's membrane (DM) is described in relation to signalment, history, and ocular disease status. Sixty-six canine eyes from the Comparative Ocular Pathology Laboratory of Wisconsin archives between 2000 and 2007 were examined. All cases were stained with hematoxylin and eosin and Alcian blue periodic acid-Schiff (PAS), while 14 cases were additionally stained with Masson's trichrome, picrosirius red, cytokeratin AE1/AE3 (CK), vimentin, and a-smooth muscle actin (SMA). Transmission electron microscopy (TEM) examination was performed in 3 corneas and in 1 normal control eye. Alcian blue PAS staining and TEM confirmed the basement membrane nature of the abnormal secondary DM. The thickness of the first DM, referred to as the corneal layer (CL) and the second or anterior chamber layer (ACL), were nearly the same, with no significant difference seen (P 5 .93). In 39% (26/66) of the eyes, a fibrous, collagenous matrix component was present between the CL and ACL, which contains vimentin-positive and a-SMA-negative spindle cells (14/14).The corneal endothelial cells in 7/14 eyes stained weakly with CK and strongly in 2 additional eyes. The most frequent histopathologically confirmed, clinical ocular histories were chronic glaucoma in 76% (50/66) of eyes, previous intraocular surgery in 36% (24/66), lens luxation in 21% (4/66), and blunt trauma in 15% (10/66) of the cases. We speculate that activation and migration of endothelial cells, in association with trauma or lens contact, play a role in the pathogenesis of this phenomenon.

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“… 1 Retrocorneal scrolls or scrolling of Descemet’s membrane is a rare finding reported in syphilitic interstitial keratitis. Our literature search identified two cases reported in 1983 and 2001, 2 , 3 and two case series of 14 eyes and five eyes with syphilitic retrocorneal scrolls in 1976 4 and 2007, 5 respectively. The patients in the reported cases underwent penetrating keratoplasty due to pseudophakic bullous keratopathy or corneal opacity and edema.…”

Section: Introductionmentioning

confidence: 99%

Descemet’s scroll in syphilitic interstitial keratitis: a case report with anterior segment evaluation and a literature review

Kasetsuwan¹,

Reinprayoon²,

Chantaren³

2015

IMCRJ

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PurposeTo present a case of syphilitic interstitial keratitis with Descemet’s scrolls, as well as its characteristic findings in an anterior segment investigation in relation to the histopathologic findings from a literature review.Case presentationA case report of a 64-year-old woman with syphilitic infection presented with band keratopathy and retrocorneal scrolls. Slit-lamp photography, confocal microscopy, anterior segment optical coherence tomography (AS-OCT), and ultrasound biomicroscopy were performed. Four previous reports were reviewed to describe the pathogenesis, natural history, and histopathologic and immunohistologic findings of the Descemet’s scroll.ResultsThe spectacle-corrected visual acuity was 20/50 and 20/30 in the right and left eyes, respectively. The scrolls appeared as a translucent web extending from Descemet’s membrane into the anterior chamber. Confocal microscopy showed decreased endothelial cell density, pleomorphism, polymegathism, and hyperreflective fibrocellular rods with central hollow. The AS-OCT and ultrasound biomicroscopy showed rod-shaped retrocorneal scrolls. The corneal thickness was 494 microns, as measured by AS-OCT. The corneal lesion remained stable during the 6-year follow-up period without the need for keratoplasty, while the previous literature reported spontaneous and postoperative corneal decompensation.ConclusionWe present a case of syphilitic interstitial keratitis with rare Descemet’s scrolls featuring relatively good visual acuity. Although we did not obtain the corneal tissue for examination, the anterior segment investigation provides insight into the underlying histopathology and natural disease history. The central hollow and cellular component seen during confocal microscopy might correspond to the amorphous core and the abnormal endothelial cells in the histopathologic findings. Failure to detect the corneal endothelium due to stromal opacity in these cases is possible, however, compromised endothelium may present.

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Immunohistochemistry and Electron Microscopy of Retrocorneal Scrolls in Syphilitic Interstitial Keratitis

Abstract: We confirmed the presence of collagens I, III, IV, VI, VIII and proteoglycans in the retrocorneal scrolls lined with attenuated endothelium. Our findings may provide further insight into the pathogenesis of keratopathy in syphilitic interstitial keratitis.

Cited by 18 publications

References 11 publications

Evaluation of Stem Cell Components in Retrocorneal Membranes

Evaluation of Stem Cell Components in Retrocorneal Membranes

Canine Duplication of Descemet's Membrane

Descemet’s scroll in syphilitic interstitial keratitis: a case report with anterior segment evaluation and a literature review

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Immunohistochemistry and Electron Microscopy of Retrocorneal Scrolls in Syphilitic Interstitial Keratitis

Abstract: We confirmed the presence of collagens I, III, IV, VI, VIII and proteoglycans in the retrocorneal scrolls lined with attenuated endothelium. Our findings may provide further insight into the pathogenesis of keratopathy in syphilitic interstitial keratitis.

Cited by 18 publications

References 11 publications

Evaluation of Stem Cell Components in Retrocorneal Membranes

Evaluation of Stem Cell Components in Retrocorneal Membranes

Canine Duplication of Descemet's Membrane

Descemet&rsquo;s scroll in syphilitic interstitial keratitis: a case report with anterior segment evaluation and a literature review

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Product

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Descemet’s scroll in syphilitic interstitial keratitis: a case report with anterior segment evaluation and a literature review