Clinicopathologic study of the cornea in X-linked ichthyosis.
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Cornea↗
Biomedical subjects
Z de la Cruz
Publications and source records attributed to Z de la Cruz.
Clinicopathologic correlation of an untreated macular hole and a macular hole treated by vitrectomy, transforming growth factor-beta 2, and gas tamponade.
PURPOSE: To study the clinicopathologic features of an untreated macular hole in the right eye and a macular hole in the left eye treated by vitrectomy, application of transforming growth factor-beta 2, and gas tamponade. METHODS: The patient, a 73-year-old man with bilateral macular holes, was studied clinically before and after surgical treatment of the macular hole in his left eye. The patient's eyes were obtained postmortem and serially step-sectioned through the macula and optic nerve head for electron microscopy. RESULTS: Examination of 1-micron thick plastic-embedded sections through the macula of the right eye disclosed a 0.6-mm macular hole with rounded gliotic margins, a thin epiretinal membrane, and parafoveal cystic changes. Examination of 1-micron thick plastic-embedded sections through the macula of the left eye disclosed a 0.25-mm defect in the fovea, which was bridged by glial cells. The glial cells were continuous with a thin hypocellular epiretinal membrane without contraction features on both sides of the defect. The ultrastructural features of the glial cells were consistent with Mueller cells. CONCLUSIONS: Treatment of a macular hole with vitrectomy, transforming growth factor-beta 2, and gas tamponade was followed by complete closure of the macular hole by Mueller cell proliferation.
Aged↗
Clinicopathologic correlation of an epiretinal membrane associated with a recurrent macular hole.
PURPOSE: To describe the clinicopathologic features of an epiretinal membrane associated with a recurrent, full-thickness idiopathic macular hole and speculate on the mechanism(s) contributing to its recurrence 1 year after initially successful closure of pars plana vitrectomy and gas tamponade (SF6). METHODS: After fixation of the 2 x 1 mm specimen in a mixture of 1% glutaraldehyde and 4% formaldehyde followed by 2.5% glutaraldehyde, postfixation with osmium tetroxide, and standard dehydration, the specimen was embedded in epoxy resin. Ultrathin sections were stained with uranyl acetate and lead citrate for transmission electron microscopy. RESULTS: Ultrastructural examination disclosed a fibrocellular membrane composed of Müller cells and fibrous astrocytes. Native collagen was entrapped in the matrix in some areas. CONCLUSION: Those cells that may lead to the closure of an idiopathic macular hole may also contribute to its recurrence if the reparative process goes awry.
Cell Membrane↗
Reassembly of corneal epithelial adhesion structures after excimer laser keratectomy in humans.
OBJECTIVE: To determine the pattern of long-term reformation of the adhesion structures after excimer laser phototherapeutic keratectomy. METHODS: Four corneal buttons were removed at penetrating keratoplasty 6 to 15 months after initial excimer laser phototherapeutic keratectomy. Morphometric analysis of electron micrographs of the wound bed was performed to determine the extent and pattern of reformation of hemidesmosomes, anchoring fibrils, and basal laminae. RESULTS: Eight percent of the basal epithelial cells had underlying normal anchoring fibrils at 6 months, compared with 35% at 15 months. The percentage of basal cell membrane occupied by hemidesmosomes remained fairly constant (35.2% to 37.7%). With the exception of a localized area of multilamination seen at 9 months, the cross-sectional area of basal lamina per 100 microns of basal cell membrane increased with the duration of wound healing (18.0 microns 2 at 6 months, 24.4 microns 2 at 15 months) but remained below normal levels (32 microns 2). CONCLUSIONS: These data suggest that after human excimer keratectomy, the anchoring fibrils and basal lamina do not completely normalize even after 15 months.
Adult↗
Clinicopathologic correlation of a macular hole treated by cortical vitreous peeling and gas tamponade.
PURPOSE: To study the histopathology of a stage III macular hole that had been treated by vitrectomy with cortical vitreous and epicortical vitreous membrane peeling and gas tamponade. METHODS: The light and electron microscopic features of a treated macular hole were studied. RESULTS: A 16-microns-wide break was present in the external limiting membrane. This was sealed by Müller cell processes. Photoreceptors adjacent to the healed defect appeared normal. No cystoid macular edema was present. CONCLUSION: Cortical vitreous peeling and gas tamponade can allow the macular hole to settle and the edges to re-approximate. The residual defect can be sealed by Müller cells.
Aged↗
Clinicopathologic correlation of choroidal neovascularization demonstrated by indocyanine green angiography in a patient with retention of good vision for almost four years.
OBJECTIVE: The clinicopathologic features of age-related macular degeneration (AMD) with occult choroidal neovascularization (CNV) detected by digital indocyanine green (ICG) videoangiography in an 82-year-old woman are discussed. METHODS: Serial sections through the macula of both eyes were prepared, and two-dimensional reconstruction maps depicting the histopathologic features were drawn. A technique by which electron microscopic examination of sections removed from glass slides was performed is described. RESULTS: Histopathologic examination of the lesion disclosed a 3.5 mm x 0.02 mm thick fibrovascular subretinal pigment epithelial choroidal neovascular membrane in an eye with diffuse basal laminar deposit in the macula. CONCLUSION: This case represents the first clinicopathologic correlation involving ICG videoangiography of CNV. The findings support the growing clinical impression that ICG videoangiography is of value in identifying what has been previously described as ill-defined or occult CNV.
Aged↗
A clinicopathologic study of posterior polymorphous dystrophy:implications for pathogenetic mechanism of the associated glaucoma.
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Adult↗
Secondary epiretinal membrane after blunt trauma.
Electron microscopic study of a surgically removed epiretinal membrane secondary to blunt trauma disclosed the membrane to be hypocellular and lined by internal limiting membrane on the external surface and by a layer of fibrocytes and myofibrocytes on the internal surface. The membrane was composed predominantly of new collagen. Occasional fibrous astrocytes, rare macrophages, and no blood vessels were present.
Adult↗
Ocular clinicopathologic study of the mitochondrial encephalomyopathy overlap syndromes.
Recent advances in molecular genetics have led to a better understanding of mitochondrially inherited diseases. Mitochondrial encephalomyopathy overlap syndrome is one such group of diseases in which ocular abnormalities are frequently manifest. The authors describe the clinical, molecular genetic, and pathologic findings of two patients with the mitochondrial encephalomyopathy overlap syndrome. The patients shared a similar clinical course with features overlapping the three traditionally distinct clinical phenotypes (the Kearns-Sayre syndrome; the syndrome of mitochondrial encephalopathy, lactic acidosis, and stroke [MELAS], and the syndrome of myoclonus, epilepsy, and ragged red fibers [MERRF]). The patients had identical mitochondrial DNA mutations (at nucleotide position 3243) and had similar ultrastructural abnormalities, including abundant enlarged mitochondria with "whorled" and "tubular" cristae. These abnormal mitochondria appeared to be preferentially distributed in cells with high metabolic activity (retinal pigment epithelium, corneal endothelium, and extraocular muscles).
Abnormalities, Multiple↗
Intraocular cilia. Report of six cases of 6 weeks' to 32 years' duration.
In this study, we describe the clinicopathologic features seen in six cases of intraocular cilia and review the features of previously reported cases. Ultrastructural studies of the cilia showed partial loss of the cuticle layer, diffuse accumulation of small electron-dense granules in cuticle and cortical cells, and loss of continuous cell membranes of the cortex. The cilia were almost completely intact in most of our cases. Intraocular cilia can be tolerated for long periods.
Adolescent↗
New sites of ocular involvement in late-infantile metachromatic leukodystrophy revealed by histopathologic studies.
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Anterior Eye Segment↗
Intraocular gnathostomiasis.
The clinical and histologic features of an intraocular parasite from a 29-year-old woman are reported. The live organism was located in the posterior vitreous near the optic disc and was successfully removed by vitreous aspiration. The parasite was identified as an advanced stage larvae of Gnathostoma spinigerum. This is the first case report of the scanning electron microscopic findings of intraocular gnathostomiasis. The features of nine previously reported cases of intraocular gnathostomiasis are reviewed.
Adult↗
Clinicopathologic study of bilateral macular holes treated with pars plana vitrectomy and gas tamponade.
The clinicopathologic findings of light and electron microscopic examination of a 78-year-old woman who underwent successful bilateral pars plana vitrectomy for bilateral stage III macular holes are reported. Examination disclosed anatomical repair of the full-thickness macular holes by glial cell proliferation in the left eye. The hole apparently collapsed with no glial cell proliferation in the right eye. The photoreceptors adjacent to the healed macular holes appeared normal. Defects in the internal limiting membrane in the foveal area were noted in both eyes.
Aged↗
Autosomal-dominant fundus flavimaculatus. Clinicopathologic correlation.
The authors report the first clinicopathologic study of autosomal-dominant fundus flavimaculatus with late-onset atrophic macular degeneration in a 62-year-old man. Results of histopathologic examination disclosed the retinal pigment epithelium (RPE) to be distended by a periodic acid-Schiff (PAS)-positive, acid mucopolysaccharide-negative material. Transmission electron microscopy showed marked accumulation of lipofuscin and melanolipofuscin granules within the RPE. The different modes of genetic transmission and ultrastructural heterogeneity suggest that fundus flavimaculatus is a clinical syndrome representing several genetically and mechanistically distinct disorders whose common end-stage is a topographically similar accumulation of lipofuscin.
Fluorescein Angiography↗
Clinicopathologic correlation of recurrent epiretinal membranes after previous surgical removal.
Recurrent epiretinal membranes (ERMs) causing macular pucker developed after surgical removal in seven eyes and were subsequently removed. A specimen was available for electron microscopic study from four of the seven primary operations and all seven of the repeat operations. The diagnostic associations for the primary cases included retinal holes or tears (four eyes), trauma, inflammation (one eye each). In one eye the membrane was idiopathic. The primary and recurrent ERM specimens contained similar cell types and structural characteristics but were not identical. No one cell type predominated in either primary or recurrent ERM. Compared with studies of idiopathic ERMs, myofibroblasts were present with increased frequency in recurrent membranes. Fibrocytes, fibrous astrocytes, and retinal pigment epithelial cells were also present in most specimens. Other features of both the primary and recurrent ERM specimens included the presence of cells with myoblastic differentiation, fragments of internal limiting membrane, new collagen, and nerve fiber elements.
Adult↗
Histopathology of tissue removed during vitrectomy for impending idiopathic macular holes.
Vitrectomy may prevent the progression of an impending macular hole by removing the layer of cortical vitreous from the posterior retina. To determine the nature of the cortical vitreous tissue, we identified and removed from the surface of the posterior retina a thin sheet of what appeared to be posterior cortical vitreous in 29 patients undergoing vitrectomy for an impending macular hole. In seven patients, the tissue was isolated for transmission electron microscopic study. Millipore filter specimens of the vitreous aspirates from all of the patients were studied by light microscopy. Vitreous condensates were present in all 29 specimens, fibrocellular membrane fragments were present in three, and fragments of internal limiting membrane were present in four. A collagen matrix was present in each of the seven specimens studied by electron microscopy, and in every specimen, the collagen's diameter was consistent with indigenous vitreous collagen. These findings confirm the presence of an acellular tissue layer on the posterior retina in eyes with an impending macular hole and indicate that it is usually indigenous vitreous collagen.
Collagen↗
Ultrastructural studies of vitreomacular traction syndrome.
We performed electron microscopic studies on seven specimens removed from the posterior retina at the time of vitrectomy for vitreomacular traction syndrome. Fibrous astrocytes were the predominant cell type in all cases. Fibrocytes were present in two cases and myofibrocytes were seen in three cases. Additional cellular and extracellular features included fragments of internal limiting membrane in six cases, old collagen in all cases, new collagen in one case, occasional macrophages in four cases, and fibrous astrocytes with myofibroblastic differentiation in one case.
Eye Diseases↗
Congenital idiopathic corneal endotheliopathy.
Two unrelated boys had a history of bilateral corneal clouding at birth following uncomplicated full-term gestations and spontaneous vaginal deliveries (without forceps). Clinical examinations disclosed bilateral corneal edema, no inflammation, and normal intraocular pressures. There was no history of similarly affected family members. The patients underwent penetrating keratoplasty at ages 4 months (patient 1) and 12 years (patient 2). Light and electron microscopic studies of the corneal buttons from both patients revealed areas of degeneration of the endothelium and separation of rounded endothelial cells. The morphologic features were strikingly similar to those in two acquired forms of corneal disorders--autoimmune endotheliopathy and "acute endotheliitis." Immunocytologic and in situ hybridization studies for herpes simplex virus were not consistent with either productive or latent corneal infection. Ultrastructural changes in Descemet's membrane reflect delayed or abnormal development of the postnatal nonbanded layer in patients 1 and 2, respectively. These suggest an intrauterine insult that resulted in endothelial dysfunction. The histologic and ultrastructural features of these two congenital cases are not typical of those seen in any of the recognized causes of congenital corneal clouding. We propose that these cases represent a unique congenital corneal endotheliopathy of undetermined origin.
Child↗