Corneal endothelial deposits in patients with cytomegalovirus retinitis.
OBJECTIVE
We studied six patients with human immunodeficiency virus (HIV) who had cytomegalovirus retinitis and abnormal endothelial deposits in at least one eye, to characterize their corneal endothelial deposits.


METHODS
The corneas of the six patients were examined by slit-lamp biomicroscopy and specular microscopy with morphometric analysis. The eyes of one patient with endothelial changes were obtained post mortem for histopathologic and ultrastructural examination.


RESULTS
There were multiple diffuse, fine refractile, stellate-shaped deposits on the corneal endothelium in all affected eyes. The deposits were best seen with retroillumination. Two of six patients examined with specular microscopy showed severe abnormalities, which included marked areas of polymegathism and decreased endothelial cell counts. Examination of one eye obtained post mortem disclosed chains of dendritic macrophages and fibrin adherent to the apical surface of the corneal endothelium. There was no evidence of direct infection of the corneal endothelium by cytomegalovirus.


CONCLUSIONS
Deposits on the corneal endothelium in patients with cytomegalovirus retinitis most likely result from an anterior uveitis. A preponderance of macrophages observed by histopathologic examination may be related to the inability of the immunodeficient patient to mount a normal T-cell response.
Walter
K A
KA
Department of Ophthalmology, Emory University, Atlanta, Georgia, USA.
Coulter
V L
VL
Palay
D A
DA
Taravella
M J
MJ
Grossniklaus
H E
HE
Edelhauser H
F
F
D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000473:pathology; D000328:Adult; D002452:Cell Count; D003316:Corneal Diseases / Q000150:complications* / Q000473:pathology; D017726:Cytomegalovirus Retinitis / Q000150:complications* / Q000473:pathology; D004728:Endothelium, Corneal / Q000473:pathology*; D006801:Humans; D008264:Macrophages / Q000473:pathology; D008297:Male; D008853:Microscopy; D008875:Middle Aged