title: Phenotypic heterogeneity of corneal endothelium in iridocorneal endothelial syndrome by in vivo confocal microscopy.
abstract: OBJECTIVE
  To present a case of iridocorneal endothelial (ICE) syndrome showing phenotypic heterogeneity of endothelial morphology between the 2 eyes of a patient as visualized by in vivo confocal microscopy (IVCM).
  
  
  METHODS
  Confocal microscopy using the Heidelberg Retina Tomograph (HRT)-3 with Rostock Cornea Module was performed bilaterally during routine follow-up on a 60-year-old lady being managed as a case of ICE syndrome with secondary glaucoma in the right eye.
  
  
  RESULTS
  IVCM revealed endothelial changes in both eyes, which however varied in morphology. Endothelium of the right eye showed a "total ICE" pattern with "ICE-type of cells," that is, diffuse involvement with enlarged, pleomorphic "epithelioid" cells having hyper-reflective nuclei and no intervening areas of the normal endothelium. The left endothelium had broad areas of normal hexagonal endothelial mosaic interspersed with different types of ICE cells showing nipple-shaped evaginations, light dark reversal and central craters with hyper-reflective rims.
  
  
  CONCLUSIONS
  This report with the help of IVCM demonstrates that though ICE syndrome is a clinical entity which classically has been considered predominantly unilateral, the endothelial changes can be bilateral and heterogeneous. The apparent heterogeneity in the present case may represent 2 different stages of the disease process at the level of the corneal endothelium-advanced disease OD and presymptomatic disease OS.
authors.affiliation: Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Chintan
authors.initials: C
authors.lastname: Malhotra
authors.forename: Surinder S
authors.initials: SS
authors.lastname: Pandav
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
authors.forename: Arun K
authors.initials: AK
authors.lastname: Jain
mesh_terms: D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D057129:Iridocorneal Endothelial Syndrome / Q000175:diagnosis*; D018613:Microscopy, Confocal; D008875:Middle Aged; D010641:Phenotype; D014792:Visual Acuity / Q000502:physiology