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M. Yamaguchi, N. Ebihara, T. Hamanaka, A. Murakami; Histological Findings of Peripheral Corneal Tissues in Three Cases of Posner-Schlossman Syndrome That Demonstrated Cytomegalovirus in the Aqueous Humor on PCR. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3941. doi: https://doi.org/.
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To investigate histological changes in peripheral corneal tissues of trabeculectomy (TLE) specimens in Posner-Schlossman syndrome that demonstrated cytomegalovirus in the aqueous humor on PCR.
A number of endothelial cells in the central area of the cornea were obtained with a specular microscope before TLE. Corneal tissues were obtained at the time of TLE and were immersed in a mixture of 2.5 % formalin and 1 % glutaraldehyde fixative. The tissue was divided into three pieces; one peice was embeded in paraffin for light microscopy, and remain pieces were embeded in epon for transmission electron microscopy. The paraffin sections were stained with HE, PAS, and antibodies against CD68 and CMV.
The number of uveitis attacks and the number of corneal endothelial cells(/mm2) (diseased eye, healthy eye) before TLE were as follows: Case 1(three times, 2325, 2932), Case 2(once, 1607, 2518), Case 3(five times, 1474, 2590). Peripheral cornea did not show positive staining for CMV in any specimens and there were no viral particles detected by transmission electron microscopy. The corneal endothelial cells seemed to be normal in case 1. Despite the single uveitis attack in case 2, decrease in the corneal endothelial count was observed in the affected eye before TLE. Histological examination demonstrated that corneal endothelial cell disappeared and Descemet membrane formed a wart. In case 3, the corneal endothelium showed karyolysis or pyknosis and vacuolation of cytoplasm. In addition, Descemet’s membrane became thickened by wart formation. Macrophage infiltration was observed in the corneal stroma and corneal endothelial cells.
These results suggested that the inflammatory response and serious corneal endothelial damage might occur in the peripheral cornea in Posner-Schlossman syndrome demonstrating CMV in the aqueous humor on PCR.
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