title: A case of Chandler's syndrome revealed by ultrastructural studies of the trabecular meshwork.
abstract: OBJECTIVE
  To investigate ultrastructural changes in the aqueous outflow route and discuss the mechanisms associated with intraocular pressure (IOP) elevation in a patient with presumably early stage Chandler's syndrome.
  
  
  METHODS
  A 47-year-old man underwent trabeculectomy because of elevated IOP. A specimen obtained during surgery was studied by transmission electron microscopy.
  
  
  RESULTS
  Electron microscopy showed the presence of a monolayer composed of corneal endothelium-like cells and thick basement membrane-like material. Neovascularization was also observed in the corneoscleral trabeculum.
  
  
  CONCLUSIONS
  Our results indicate that several mechanisms, including the formation of basement membrane-like tissue, infiltration of inflammatory cells and neovascularization, might contribute to the elevation of IOP in Chandler's syndrome. These may occur even when there is no history of conspicuous inflammatory reaction in the anterior ocular segments.
authors.affiliation: Department of Ophthalmology and Visual Science, Kumamoto University Graduate School of Medical Sciences, 1-1-1 Honjo, Kumamoto 860-8556, Japan. maikoa-75@k7.dion.ne.jp
authors.forename: Maiko
authors.initials: M
authors.lastname: Awai
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Futa
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Hamanaka
authors.forename: Akira
authors.initials: A
authors.lastname: Hirata
authors.forename: Takahisa
authors.initials: T
authors.lastname: Koga
authors.forename: Akira
authors.initials: A
authors.lastname: Kimura
authors.forename: Tomoko
authors.initials: T
authors.lastname: Miyagawa
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Tanihara
mesh_terms: D001082:Aqueous Humor / Q000378:metabolism; D001485:Basement Membrane / Q000648:ultrastructure; D004728:Endothelium, Corneal / Q000473:pathology*; D005128:Eye Diseases / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D008264:Macrophages / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000473:pathology; D009798:Ocular Hypertension / Q000601:surgery; D013577:Syndrome; D014129:Trabecular Meshwork / Q000098:blood supply / Q000648:ultrastructure*; D014130:Trabeculectomy