Cytopathology of adenovirus keratitis by replica technique.

Corneal replicas were made from the severely affected eyes of 12 patients presenting with typical signs and symptoms of epidemic keratoconjunctivitis. Adenovirus was isolated from the eyes. Histopathological study of the replicas and cytology of diseased cells removed with the replica showed diffuse mild oedema of the epithelium, with scattered moderately swollen and deformed cells. The clinically observed punctate lesions histologically consisted of markedly swollen cells that had become oval or rounded. Fusion of these cells led to small syncytial formations, and the development of pseudopodia-like processes was occasionally observed. Loss of cell contents resulted in the formation of plicae on the surface of many cells. Two types of inclusion bodies were detected in the epithelial cells. The first type, intranuclear vacuolar inclusions, contained homogeneous material. The second type of inclusions were round, dense bodies, that developed in the homogeneous material of intranuclear vacuolar inclusions. The dense bodies contained the replicating and maturing virus particles. After cell degeneration the dense bodies become extracellular. Making a corneal replica had a beneficial effect on the clinical course of adenovirus keratitis.