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An Incipient Iridocorneal Endothelial Syndrome?

E. Lee Stock, MD; Sanford I. Roth, MD; David Morimoto, MD

Arch Ophthalmol. 1987;105(10):1378-1381.

Abstract
• Unilateral, noninfectious, nontraumatic corneal endotheliopathy was noted in a 34-year-old man who had had blurred vision for five years without evidence of iridic disease or glaucoma. Ultrastructural studies demonstrated focal necrosis of the corneal endothelial cells, with desquamation of the cells into the anterior chamber. The corneal endothelium appeared to expand beneath the dying endothelial cells, indicating reendothelialization of the cornea. There was no epithelialization of the endothelium, as evidenced by the lack of keratin production or desmosome formation. Descemet's membrane was thickened with edema, a posterior collagenous layer, and fibrous, long-spacing collagen. These alterations in Descemet's membrane were similar to those described for other corneal dystrophies. It is proposed that this unilateral desquamating endotheliopathy represents an incipient form or a forme fruste of the iridocorneal endothelial syndrome.

Author Affiliations
From the Cornea and External Eye Disease Laboratory, Veterans Administration Lakeside Medical Center, Chicago (Drs Stock and Morimoto); and Departments of Ophthalmology (Drs Stock and Morimoto) and Pathology (Dr Roth), Northwestern University Medical School, Chicago.

Footnotes
Accepted for publication June 25, 1987.

Presented in part at the 25th Annual Meeting of the Georgianna Theobald Dvorak Ophthalmic Pathology Society, New Orleans, March 7, 1986.

Reprint requests to Department of Ophthalmology, Northwestern University Medical School, 303 E Chicago Ave, Chicago, IL 60611 (Dr Stock).

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