Immunohistochemistry and electron microscopy of retrocorneal scrolls in syphilitic interstitial keratitis.
OBJECTIVE
To describe the immunohistochemical and electron microscopic characteristics of retrocorneal scrolls in syphilitic interstitial keratitis.


METHODS
Five eyes of five patients with congenital syphilitic interstitial keratitis who underwent keratoplasty for corneal opacities and corneal edema were studied. The corneal buttons were processed for histologic examination with hematoxylin and eosin staining and underwent immunohistochemistry stainings for collagen types I, III, IV, V, VI, VIII, fibronectin, laminin, and decorin. The corneal buttons were also processed for transmission electron microscopy and immunoelectron microscopy.


RESULTS
Light microscopy revealed that the retrocorneal scrolls had a multilayered, amorphous, acellular matrix. All scrolls were lined with attenuated corneal endothelial cells. The Descemet membranes in all specimens had areas of irregular thickening with attenuated endothelium. Immunohistochemical assessment of the scrolls showed positive staining for collagens I, III, IV, VI, VIII, fibronectin, laminin, and decorin but not for alpha -SMA. Immunoelectron microscopy confirmed these findings. Transmission electron microscopy showed multilaminar disorganized structures in scrolls composed of long- and short-fiber collagens.


CONCLUSIONS
We confirmed the presence of collagens I, III, IV, VI, VIII and proteoglycans in the retrocorneal scrolls lined with attenuated endothelium. Our findings may provide further insight into the pathogenesis of keratopathy in syphilitic interstitial keratitis.
Dogru
Murat
M
Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan. muratodooru@yahoo.com
Kato
Naoko
N
Matsumoto
Yukihiro
Y
Tanaka
Yoichi
Y
Akabane
Naoko
N
Shimmura
Shigeto
S
Tsubota
Kazuo
K
Shimazaki
Jun
J
D000328:Adult; D003094:Collagen / Q000378:metabolism; D003315:Cornea / Q000378:metabolism* / Q000648:ultrastructure*; D058575:Decorin; D003886:Descemet Membrane / Q000473:pathology; D004728:Endothelium, Corneal / Q000473:pathology; D016326:Extracellular Matrix Proteins / Q000378:metabolism; D005260:Female; D005353:Fibronectins / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D007634:Keratitis / Q000151:congenital / Q000378:metabolism / Q000382:microbiology* / Q000473:pathology*; D007797:Laminin / Q000378:metabolism; D008297:Male; D008854:Microscopy, Electron; D016253:Microscopy, Immunoelectron; D008875:Middle Aged; D020033:Protein Isoforms / Q000378:metabolism; D011509:Proteoglycans / Q000378:metabolism; D013587:Syphilis
C546878:DCN protein, human; D058575:Decorin; D016326:Extracellular Matrix Proteins; D005353:Fibronectins; D007797:Laminin; D020033:Protein Isoforms; D011509:Proteoglycans; D003094:Collagen