Abstract
Abstract: :
Purpose:To correlate the histophathological findings and the fluorangiographic images of the vascularized cornea 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 and 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 four cases before mentioned showed basal lamina discontinuity of the vessels' wall and wide fenestrations. In the endothelial junctions 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. Conclusion:In the preliminary results four of 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.
Keywords: 483 neovascularization • 472 microscopy: electron microscopy • 430 imaging/image analysis: clinical