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Collagen fiber changes related to keratoconus with secondary corneal amyloidosis

Authors Araki-Sasaki K, Osakabe Y, Fujita K, Miyata K, Hirano K

Received 16 January 2018

Accepted for publication 17 March 2018

Published 30 August 2018 Volume 2018:11 Pages 193—199

DOI https://doi.org/10.2147/IMCRJ.S162655

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Andrew Yee

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Kaoru Araki-Sasaki,1 Yasuhiro Osakabe,2 Koji Fujita,2 Kazunori Miyata,3 Koji Hirano4

1Department of Ophthalmology, Japan Community Health Care Organization, Hoshigaoka Medical Center, Hirakata, Japan; 2Department of Molecular Pathology, Tokyo Medical University, Tokyo, Japan; 3Department of Ophthalmology, Miyata Eye Hospital, Miyakonojo, Japan; 4Department of Ophthalmology, Ban Buntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan

Abstract: We describe the histological changes in the collagen fibers of a 50-year-old male who presented keratoconus with secondary corneal amyloidosis. Corneal tissue from the patient was obtained following a penetrating keratoplasty and was subjected to histochemical analysis using Masson’s trichrome staining, Congo red staining, anti-lactoferrin antibody, and anti-transforming growth factor-beta-induced protein (TGFBIp) antibody. A Congo red-positive region was detected in the anterior half of the stroma in the center and inferior cornea. Although hemotoxylin and eosin staining revealed irregularity in the Congo red-positive region, other parts of the stroma did not show any abnormalities. Positive staining both by anti-TGFBIp and anti-lactoferrin antibodies was observed in the Congo red-positive region. Interestingly, all the layers of the corneal stroma, including the peripheral region, were positively stained by anti-TFGBIp antibody, even in the Congo red-negative area. Masson’s trichrome staining also showed irregular staining throughout the corneal stroma, even outside of the Congo red-positive region. Additionally, Bowman’s layer, which consists of collagen type IV, was damaged. TGFBIp was strongly expressed and Masson’s trichrome staining was reduced throughout the entire keratoconic stroma. The constant qualitative changes in keratoconic collagen fibers, along with the observed abnormality in the Bowman’s membrane, might point to the pathogenesis of secondary corneal amyloidosis in keratoconus.

Keywords: cornea, amyloid, stroma, TGFBIp, lactoferrin

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