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ABSTRACT
Purpose: To investigate an immunopathogenesis of central and paracentral corneal ulceration associated with rheumatoid arthritis.
Methods: Sparse infiltrating cells in the ulcer area were identified by immunohistochemistry applied to archived formalin fixed, paraffin embedded tissues that had been recovered from patients undergoing penetrating keratoplasty necessitated by rheumatoid-associated central or paracentral corneal ulceration.
Results: Clinically, the ulcers presented as non-infiltrated lesions with a modicum of other ocular inflammation. Sparse T-lymphocytes were consistently identified in the subepithelial areas adjacent to the ulcer, with some neutrophils and macrophages in the stroma. B-lymphocytes were not detected. MHC Class II antigens reactivity was noted on some infiltrating cells and on corneal endothelium of two specimens.
Conclusions: Immunohistochemistry of archival tissue facilitated detection and identification of sparse infiltrate in this infrequent corneal melting. Selective, consistent finding of T-lymphocyte infiltration in the ulcer area supports an immunopathogenesis of this clinical entity.
DECLARATION OF INTEREST
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
FUNDING
This work was supported by U.S. Public Health Service NIH grant EY06866 (CMK), Rochester Eye and Human Parts Bank (RDP) and an unrestricted grant from Research to Prevent Blindness, Inc. to the University of Rochester Department of Ophthalmology. The authors thank Loel Turpin and Mary Georger for skillful technical assistance and William Fischer and Rachel Hollar for expert photographic assistance.