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Investigative Ophthalmology & Visual Science, Vol 38, 1896-1901, Copyright © 1997 by Association for Research in Vision and Ophthalmology

ARTICLES AND REPORTS

Endothelial metaplasia in the iridocorneal endothelial syndrome

DN Howell, T Damms, JL Burchette Jr and WR Green
Department of Pathology, Veterans Affairs Medical Center, Durham, North Carolina, USA.

PURPOSE: To test the hypothesis that the aberrant, cytokeratin- expressing cells that replace endothelium in the iridocorneal endothelial (ICE) syndrome are of endothelial origin. METHODS: Corneas from four patients with Chandler's syndrome and three with essential iris atrophy were examined by two-color immunofluorescence for simultaneous expression of cytokeratins and two markers of endothelial lineage: vimentin and the antigen recognized by the antiendothelial monoclonal antibody 2B4.14.1. RESULTS: In six corneas, unequivocal endothelial staining for cytokeratins was present; in each of these, cells coexpressing cytokeratins and the two endothelial markers were clearly identifiable. In the remaining cornea, weak cytokeratin staining that colocalized with vimentin was present. CONCLUSIONS: These results lend strong support to the hypothesis that the "epithelial- like" endothelial cells in ICE syndrome are cells of endothelial lineage rather than heterotopia of epithelial cells; these cells probably arise via a metaplastic transformation of preexisting endothelium.


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