ABSTRACT
A migrating endothelial rejection line is the clinical criterion of specific immune reaction in corneal allotransplantation. This line when seen in otherwise intact corneas has been presumed to be an autoimmune endotheliopathy. We have recorded corneal changes similar to autoimmune endotheliopathy in four of ten patients with the diagnosis of pars planitis. These observations suggest that pars planitis may be an autoimmune process directed against the vitreous humor.
Subject(s)
Autoimmune Diseases/pathology , Vitreous Body/pathology , Adult , Child , Child, Preschool , Corneal Diseases/pathology , Endothelium/pathology , Eye Diseases/pathology , Female , Humans , MaleABSTRACT
Specular microscopy of endothelium after corneal transplantation has often shown a sharp reduction in its number density immediately after surgery and long-term cell loss during the next three to four years in addition to continuous morphologic changes. We examined flat preparations of the endothelium of three corneal buttons removed three weeks, eight weeks, and 11 months after penetrating keratoplasty and compared them to similar preparations from the corneal rims of the respective donors. We did not find significant morphologic changes, and direct endothelial cell counts disclosed an endothelial cell loss of 3.8% at three weeks, 2.6% at eight weeks, and 5.6% at 11 months after keratoplasty. We believe the lack of endothelial cell loss and absence of morphologic changes in these specimens are direct results of our surgical technique.
