A comparative study on morphology of corneal endothelium and Descemet membrane, TGF-β1 aqueous humor level in Fuchs endothelial corneal dystrophy and pseudophakic bullous keratopathy

Abstract

BACKGROUND: Chronic corneal edema is often associated with endothelial cell loss due to Fuchs endothelial dystrophy and pseudophakic bullous keratopathy.

AIM: to compare the changes of Descemet membrane/endothelium complexes and aqueous humor TGF-β1 level in Fuchs endothelial dystrophy and pseudophakic bullous keratopathy.

MATERIALS AND METODS: The study included 35 patients (36 eyes) with chronic corneal edema caused by irreversible dysfunction of endothelial cells: 1a group — 12 patients (12 eyes) with Fuchs endothelial dystrophy, 1b group — 10 patients (10 eyes) with pseudophakic bullous keratopathy; 2a group — 8 patients (9 eyes) with Fuchs endothelial dystrophy, 2b group — 5 patients (5 eyes) with pseudophakic bullous keratopathy. Control groups — 5 (for groups 1a, 1b) and 7 (for groups 2a, 2b) donor corneoscleral discs.

TGF-β1 level in patients of groups 1a, 1b was determined by enzyme immunoassay of intraocular fluid. Descemet membrane/endothelium çomplexes (1a, 1b groups and control group (5 of 12 preserved human corneas) were stained with hematoxylin/eosin. Descemet membrane/endothelium çomplexes (2a, 2b groups and control group (7 of 12 preserved human corneas) were stained with ZO-1, α-SMА antibodies, nuclei were counterstained (Hoechst 33342).

RESULTS: TGF-β1 level was elevated in 1a group (p <0.05). In 1a group Descemet membrane was thickened by guttae. Descemet membrane/endothelium çomplexes of 2a, 2b groups presented enlarged endothelial cells with lower levels of ZO-1 expression. There was an increase in nuclear areas in 2a, 2b groups compared to controls (p <0.05). Nuclear aspect ratio was lower in 2a, 2b groups compared to the controls (p <0.05). In 2a group endothelial cells showed high level of α-SMА expression.

CONCLUSION: Fuchs endothelial dystrophy and pseudophakic bullous keratopathy are conditions of different structural changes in Descemet membrane/endothelium çomplexes. TGF-β1 may play a pivotal role in guttae formation in Fuchs endothelial dystrophy.

Keywords

corneal endothelium / Descemet membrane / Fuchs endothelial dystrophy / bullous keratopathy / TGF-β1 / ZO-1

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