An Immunohistochemical Study of Inflammatory Cell Changes and Matrix Remodeling With and Without Acute Hydrops in Keratoconus.
OBJECTIVE
To determine the inflammatory cell and matrix changes in advanced keratoconus, including acute hydrops, using immunohistochemical analysis.


METHODS
The corneal tissue from eight subjects with keratoconus undergoing corneal transplantation (three keratoconic buttons, five buttons post acute hydrops—one of them with extensive neovascularization following hydrops) was compared with tissue from two normal corneoscleral rims (n = 10). The corneas were sectioned and analyzed with specific markers for macrophages, lymphocytes, dendritic cells, and scar associated matrix molecules laminin, fibronectin, tenascin-C, and type III collagen.


RESULTS
Populations of cells using markers for macrophages, leucocytes and antigen presenting cells were found to be associated with the epithelium and stroma of keratoconic tissue. Populations of these cells appeared decreased in hydrops-associated keratoconus except for a large increase in leucocytes in the stroma and endothelium associated with neovascularization. Extracellular matrix deposition was found to be uniquely demonstrated in localized areas of the stroma, corresponding to the site of hydrops involvement.


CONCLUSIONS
Immunohistochemical analysis revealed a chronic, inflammatory process with recruitment of immunoinflammatory cells and deposition of scar tissue in keratoconus. The inflammatory markers were somewhat attenuated in hydrops-associated keratoconus corneas and thus inflammation was not considered to be a major factor in the development of acute corneal hydrops.
Jennifer C
JC
Fan Gaskin
I-Ping
IP
Loh
Charles N J
CN
McGhee
Trevor
T
Sherwin
D000208:Acute Disease; D015703:Antigens, CD / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D003315:Cornea / Q000378:metabolism; D015715:Corneal Edema / Q000276:immunology / Q000378:metabolism* / Q000473:pathology*; D016326:Extracellular Matrix Proteins / Q000378:metabolism*; D005500:Follow-Up Studies; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D007640:Keratoconus / Q000276:immunology / Q000378:metabolism* / Q000473:pathology*; D037181:Lectins, C-Type / Q000378:metabolism; D007962:Leukocytes / Q000166:cytology; D008264:Macrophages / Q000166:cytology
D015703:Antigens, CD; D015415:Biomarkers; D016326:Extracellular Matrix Proteins; D006684:HLA-DR Antigens; D037181:Lectins, C-Type