School of Clinical and Laboratory Sciences, University of Manchester, Manchester, United Kingdom.
Pathology. 2012 Apr;44(3):234-9. doi: 10.1097/PAT.0b013e3283511b42.
The aims of this study were to re-assess the histopathology of the disease by introducing more modern measuring techniques and to determine if axial stromal thinning, which is the most apparent change, is related to the other alterations observed.
Recipient keratoconic corneas from 36 patients following corneal transplantation were studied. Haematoxylin and eosin (H&E) and periodic acid-Schiff (PAS) staining were used to identify breaks in Bowman's layer and Descemet's membrane. Thickness of corneal layers was measured by Leica QWin software. Epithelial and stromal thickness were measured in each sample at the periphery of the corneal button and at the area of maximal stromal thinning. The presence of apoptotic cells in Bowman's layer breaks was detected by terminal deoxynucleotidyl transferase mediated dUTP-X nick end labelling.
In all 36 corneal samples the central stroma, at the apex of the cone, was thinner than the peripheral. There was a negative correlation between central stromal and central epithelial thickness (p = 0.009). Bowman's layer breaks were found in 92% of corneas. Apoptotic cells were detected at the level of Bowman's breaks membrane. We found a positive correlation between epithelial thickness and the number of Bowman's layer breaks (p = 0.009 for central epithelial thickness and p = 0.003 for peripheral epithelial thickness). Descemet's membrane deformities were observed in 19% of corneas and central stromal thickness of these corneas was significantly less than corneas without breaks (p = 0.006).
There are various different histopathological features associated with keratoconus and some of them are very subtle and not very well studied. Accurate measurements also suggest some correlations between them. Stromal thinning is associated with the number of breaks in Descemet's membrane, but it is the thickening of the epithelium which is associated with breaks in Bowman's layer.
本研究旨在通过引入更现代的测量技术来重新评估疾病的组织病理学，并确定最明显的改变——轴向基质变薄是否与其他观察到的改变有关。
对 36 例角膜移植后供体圆锥角膜进行研究。苏木精和伊红（H&E）及过碘酸希夫（PAS）染色用于识别 Bowman 层和 Descemet 膜的破裂。使用 Leica QWin 软件测量角膜各层的厚度。在角膜环的周边和基质最薄区域测量每个样本的上皮和基质厚度。通过末端脱氧核苷酸转移酶介导的 dUTP-X 缺口末端标记法检测 Bowman 层破裂处凋亡细胞的存在。
在所有 36 例角膜样本中，中央基质在圆锥顶点处比周边薄。中央基质与中央上皮厚度呈负相关（p=0.009）。92%的角膜存在 Bowman 层破裂。在 Bowman 层破裂膜处检测到凋亡细胞。我们发现上皮厚度与 Bowman 层破裂数量呈正相关（中央上皮厚度 p=0.009，周边上皮厚度 p=0.003）。19%的角膜存在 Descemet 膜变形，这些角膜的中央基质厚度明显小于无破裂的角膜（p=0.006）。
圆锥角膜存在多种不同的组织病理学特征，其中一些非常细微且研究较少。准确的测量还提示它们之间存在一些相关性。基质变薄与 Descemet 膜破裂数量有关，但与 Bowman 层破裂有关的是上皮增厚。
