Visualizing morphological features of diseases of the corneal endothelium

Aims/Purpose: To study several corneal endothelial diseases in order to find a set of morphological characteristics for each disease.

Methods: Human cornea samples were collected from patients receiving a corneal transplant that involved the endothelium. Samples were fixed and immunofluorescently stained using antibodies against the nucleus, actin cytoskeleton, Beta‐catenin and the ZO‐1 junctional protein. Images were analyzed and variation in cell size and percentage of hexagonal cells were compared to in vivo specular microscopy to validate the staining methods. Images were then further analyzed to find new characteristics for the different diseases.

Results: Samples were collected from patients with healthy endothelial cells, Fuchs’ endothelial corneal disease, Pseudophakic bullous keratopathy, rejection of a previous corneal graft, failed corneal graft, inflammatory corneal melt and congenital hereditary endothelial dystrophy. A set of parameters for each disease was established which included newly described features such as leukocyte transendothelial migration, morphology of the interdigitations on the basal surface of the cells and the presence of multinucleated cells.

Conclusion: We have established morphological parameters for several diseases affecting the corneal endothelium. These can be used for further studies into the pathological mechanisms of each disease and possibly in the development of future therapies.