Betech HM, Baca LO, Velasco R, Levine A, Rodríguez RA, Rosales MML

Language: Spanish
References: 24
Page: 164-170
PDF size: 260.74 Kb.

ABSTRACT

Purpose: To correlate the histophathological findings and the fluorangiographic images of the vascularized corneas obtained by penetrating keratoplasty and try to explain why some vessels of neoformation leak and some others does not leak.
Methods: This is the fourth stage of a corneal fluorangiographic trial. A prospective, transversal, descriptive and observational study was carried out in the period comprehended between March and November 2001 in the Cornea Department of the FHNSL. We studied five patients with corneal neovascularization by corneal fluorangiography, which needed of visual rehabilitation by penetrating keratoplasty. The corneal graft was studied by light and electron microscopy and was correlated with the corneal fluorangiography.
Results: Five buttons were obtained, all of them matching with the inclusion criteria, except one in which only electron microscopy was done. In the corneal fluorangiography case 1 did not leak, and cases 2, 3, 4 did showed leakage forming ‘bulb’ images. Light microscopy diagnosis of case 1 was Corneal Pannus and in cases 2, 3, 4 and 5 Interstitial Keratitis. Electron microscopy of all cases before mentioned showed basal lamina discontinuity of the vessels and wide fenestrations. In the endothelial junctions from small vessels we could see alterations of the zonulae occludentes: discontinuity of the membrane, less filamentary structures, responsible of the cell mobility, less pinocytic vesicles, responsible of substance transportation and a higher number of vacuoles. In the nuclear structures of the endothelial cells we observed prominent nucleolus, more nuclear indentations and data compatible with embryonic vessels like nuclear pores.
Conclusions: In the preliminary results all the study items showed similar alterations in the vascular basal lamina and endothelial cell structures, characteristics not found in a normal vessels, which have a direct relation in the substance transportation thru the vascular wall. Histopathological findings could explain the corneal fluorangiographic alterations and how they intervene in the leakage of many substances, which may interfere with the evolution of the Interstitial Keratitis.

REFERENCES

1. Baer J, Foster S. Corneal Laser Photococoagulation or Treatment of Neovascularization. Efficacy of 577 nm Yellow Dye Laser. Ophthalmology 1992; 99(2):173-179.

2. Baca O, Velasco R, López L y cols. Fluorescein Angiography in Corneal Disorders. B350. ARVO, IOVS 1996: 37(3):547.

3. Poblano M, Baca O, Velasco R y cols. Fluorangiofrafía Corneal. B701 ARVO, IOVS 1999; 40(4):1093.

4. Vieyra M, Baca O, Velasco R y cols. Fluorangiografía Corneal: Fase III, ARVO, IOVS 2000.

5. Burger P, Chandler D y cols. Experimental Corneal Neovascularization: Biomicroscopic, Angiographic, and Morphologic Correlations. Cornea 1985-86; 4(1):35-41.

6. Leibowitz HM, Waring GO. Corneal Disorders, Clinical Diagnosis and Management. 2nd Edition. WB Saunders Company, 1998, Cap. 6, 154-178.

7. Gan L, Fagerholm P. Leukocytes in the early events of the corneal neovascularization. Cornea 2001; 20(1):96-9.

8. Sennlaub F, Courtois Y, Goureau O. Nitric Oxide Synthase-II Is Expressed in Sever Corneal Alkali Burns and Inhibits Neovascularization. IOVS 1999, 40(12):2773-2779.

9. Dixon W, Bron A. Fluorescein Angiographic Demonstration of Corneal Vascularization in Contact Lens Wearers. Am J Ophthalmol 1973; 75(6):1010-1015.

10. Philipp W, Speicher L, Humpel C. Expression of Vascular Endothelial Growth Factor and its Receptors in Inflamed and Vascularized Human Corneas. IOVS 2000; 41(9);2154-2522.

11. Crusiefen C, Rummelt C, Kuchle M. Immunohistochemical Localization of Vascular Endothelial Growth Factor, Transforming Growth Factor Alpha, and Transforming Growth Factor Beta in Human Corneas with Neovascularization. Cornea 2000; 19(4):526-533.

12. Huang AJ, Watson BD, Hernandez E, Tseng SC. Induction of conjunctival transdifferentiation on vascularized corneas by phototrombotic occlusion of corneal neovasculariztion. Ophthalmol 1988; 95(2)-228-235.

13. Pillai CT, Dua HS, Hossain P. Fine Needle Diathermy Occlusion of Corneal Vessels. Invest Ophthalmol Vis Sci 2000; 41(8):2148-2153.

14. Poblano ML, Baca O, Velasco R y cols. Queratitis intersticial, variantes de presentación. Boletín del Hospital Oftalmológico de Nta. Sra. De la Luz 1998, 180:53-57.

15. Hori S. Pathophysiology of Intraocular Neovascularization. Nippon Ganka Gakkai Zasshi 1990; 94(12):1103-21.

16. Ormerod LD, Fariza E, Hughes GW, Doane MG, Webb RH. Anterior segment fluorescein videoangiography with a scanning angiographic microscope. Ophthalmol 1990; 97:745-751.

17. Watson PG. Anterior segment fluorescein angiography in the surgery of immunologically induced corneal and scleral destructive disorders. Ophthalmol 1987; 94(11)1452-1464.

18. Watson P, Booth-Mason S. Fluorescein angiography in the differential diagnosis of sclerokeratitis. Br J Ophthalmol 1987; 71(2):145-151.

19. Easty DL, Bron AJ. Fluorescein angiography of the anterior segment. Its value in corneal disease. Br J Ophthalmol 1971; 55(10):671-682.

20. Motolese E y cols. Fluorangiography of Various Pathlological Pictures in Unnusual Observations of the Anterior Segment. Boll Soc Ital Biol Sper 1984; 60(6):1253-1259.

21. Gillies WE, Brooks AM. Disorders of Perfusion of the Anterior Segment of the Eyes. Aust N Z J Ophthalmol 1996; 24(3):169-187.

22. Kuckelkorn R y cols. Video Fluorescein Angiography of the Anterior Segment in Severe Eye Burns. Acta Ophtalmol Scand 1997; 75(6):675-680.

23. Saari KM. Anterior Segment Fluorescein Angiography in Inflammatory Disease of the Cornea. Acta Ophthalmol (Copenh) 1979; 57(5):781-793.

24. Fetkenhour CL, Choromokos E. Anterior Segment Fluorescein Angiography With Retinal Fundus Camera. Arch Ophthalmol 1978, 96:711-713.