Purpose. Evaluation of pathologic changes in cornea buttons and conjunctiva removed from patients with erythema multiforme major. Methods. Histopathologic examination using light microscopy with routine and special stains of 9 native corneas, 2 grafted corneas, and 4 conjunctival specimens removed for penetrating keratoplasty or keratoprostheses. Results. The corneas showed several consistent patterns of injury. The epithelium was either severely denuded (77.8%) or showed marked hyperplasia (33.3%). An inflammatory pannus was commonly (88.9%) seen with stromal neovascularization (88.9%) and chronic inflammatory infiltration (77.8%) of the anterior half of the cornea (100.0%). The stromal was scarred (88.9%) and thinned (77.8%). Endothelial attenuation was frequent (88.9%). The corneal grafts transplanted into Stevens-Johnson patients had changes similar to those in the native cornea including inflammatory pannus and anterior corneal vascularization (100.0%). The conjunctiva biopsies revealed acanthosis and keratinization similar to the corneal specimens (50.0%), a loss of goblet cells (75.0%), chronic stromal infiltration and scarring (75.0%). Conclusions. This study, which represents the only histopathologic series focusing on the corneal changes in erythema multiforme major, indicates that pannus and neovascularization ot the anterior cornea is a common pathway for corneal injury in Stevens-Johnson syndrome and that corneal grafts are subject to the same destructive processes.
|Original language||English (US)|
|Journal||Investigative Ophthalmology and Visual Science|
|State||Published - Feb 15 1996|
ASJC Scopus subject areas
- Sensory Systems
- Cellular and Molecular Neuroscience