Lee W R, Marshall G E, Kirkness C M
University of Glasgow, Department of Ophthalmology.
Br J Ophthalmol. 1994 Aug;78(8):624-31. doi: 10.1136/bjo.78.8.624.
A corneal disc, obtained from a 52-year-old woman suffering from an early stage of the iridocorneal endothelial syndrome (ICE), was investigated by various morphological techniques to analyse the structural variations in the endothelial cells and to identify the collagen types within the abnormal layer of Descemet's membrane. Scanning electron microscopy of the posterior corneal surface revealed a mosaic of (a) flat hexagonal cells resembling irregular but normal endothelial cells, and (b) rounded hexagonal (ICE) cells with numerous surface microvilli. Degenerative changes were present in each cell type, but were more common in the flat hexagonal cells which contained intracytoplasmic spaces. By transmission electron microscopy the flat hexagonal cells exhibited many of the features of normal endothelial cells in terms of organelles and intercellular attachments, but lateral invaginations were absent. The ICE cells differed in that the apical surface was covered by microvilli and the cytoplasm contained tonofilaments, which were also observed by light microscopic immunocytochemical staining. Most commonly, intercellular attachments were rudimentary in both types of cell and intercellular spaces were dilated, but desmosomes were sometimes prominent in the ICE cells where interdigitations were pronounced. In some sectors, the basal surface of the ICE cells was indented by deposition of clumps of fibrillar collagenous material. An immunocytochemical study of the abnormal posterior deposits localised type IV collagen to the amorphous matrix and collagen types III and V, but not type I, to the collagen fibril bundles. Mononuclear inflammatory cells were identified between the ICE cells in the monolayer. The evidence suggests that some of the flat hexagonal cells were undergoing a degenerative change while others were transforming into ICE cells.
从一名患有虹膜角膜内皮综合征（ICE）早期的52岁女性获取的角膜片，通过各种形态学技术进行研究，以分析内皮细胞的结构变化，并确定Descemet膜异常层内的胶原类型。角膜后表面的扫描电子显微镜显示出由以下两种细胞组成的镶嵌图案：（a）扁平六边形细胞，类似于不规则但正常的内皮细胞；（b）圆形六边形（ICE）细胞，具有许多表面微绒毛。每种细胞类型都存在退行性变化，但在含有胞质内间隙的扁平六边形细胞中更为常见。通过透射电子显微镜观察，扁平六边形细胞在细胞器和细胞间连接方面表现出许多正常内皮细胞的特征，但没有侧向内陷。ICE细胞的不同之处在于，其顶端表面覆盖有微绒毛，细胞质中含有张力丝，这也通过光镜免疫细胞化学染色观察到。最常见的是，两种细胞类型的细胞间连接都不发达，细胞间间隙扩张，但在指状交叉明显的ICE细胞中，桥粒有时很突出。在一些区域，ICE细胞的基底表面因纤维状胶原物质团块的沉积而凹陷。对异常后沉积物的免疫细胞化学研究将IV型胶原定位到无定形基质中，将III型和V型胶原而非I型胶原定位到胶原纤维束中。在单层的ICE细胞之间鉴定出单核炎性细胞。证据表明，一些扁平六边形细胞正在发生退行性变化，而另一些正在转化为ICE细胞。
