Features of the iridocorneal endothelial syndrome on confocal microscopy.
OBJECTIVE
To present a subtle case of iridocorneal endothelial (ICE) syndrome and discuss the utility of in vivo confocal microscopy in the evaluation of this disorder. Previous reports of the confocal microscopic features of ICE syndrome are reviewed.


METHODS
A 32-year-old man presented with decreased vision and halos. Slit-lamp biomicroscopy and in vivo confocal microscopy were used to evaluate the etiology of his complaints. Clinical photographs and confocal micrographs were analyzed.


RESULTS
In vivo confocal microscopy revealed marked asymmetry between the right and left corneal endothelial layers with pleomorphic epithelioid cells on the right, some with hyperreflective nuclei. A transition between cells with uniform appearance and dark nuclei and a highly irregular cellular arrangement with hyperreflective nuclei was present.


CONCLUSIONS
This report supports the clinical utility of in vivo confocal microscopy in the evaluation of ICE syndrome. It demonstrates that the histopathologic features of ICE syndrome on scanning electron microscopy may be shown clinically using high-resolution confocal microscopy.
Garibaldi
Daniel C
DC
Cornea and Anterior Segment Service, The Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD 21287, USA.
Schein
Oliver D
OD
Jun
Albert
A
D000328:Adult; D015715:Corneal Edema / Q000473:pathology*; D003937:Diagnosis, Differential; D004728:Endothelium, Corneal / Q000473:pathology*; D006801:Humans; D007499:Iris Diseases / Q000473:pathology*; D008297:Male; D018613:Microscopy, Confocal; D013577:Syndrome