Chandler's syndrome as a variant of essential iris atrophy. A clinicopathologic study
M. M. Rodrigues, B. W. Streeten and G. L. Spaeth
Trabeculectomy and peripheral iridectomy specimens from one male and two
female patients with Chandler's syndrome (age, 30 to 42 years) showed that
all had unilateral corneal endothelial "dystrophy," corneal edema, mild to
moderate iris atrophy without holes, peripheral anterior synechiae, and
glaucoma. In one, fluorescein angiography of the iris disclosed a sector
filling delay of limbal and conjunctival vessels and pupillary and
extrapupillary leakage. Histopathologic examination showed a layer of
degenerated corneal endothelium and Descemet's membrane extending across
the inner uveal trabeculum. Descemet's membrane displayed irregular,
nodular, scroll-like excrescences in some cases, and thinner placoid
configurations with abnormal widely spaced collagen (100 nm) in others.
Corneal endothelial cells exhibited increased microvilli, widened cellular
interdigitations, and occasional shrunken cells with enlarged or disrupted
cytoplasmic blebs. Peripheral iris specimens displayed mild to moderate
stromal atrophy without vascular occlusions. Pigment epithelium was normal.