Korean J Ophthalmol.  2013 Dec;27(6):416-420. 10.3341/kjo.2013.27.6.416.

The Pathologic Characteristics of Pingueculae on Autofluorescence Images

• Kim TH
• Chun YS
• Kim JC

• KMID: 1792076
• DOI: http://doi.org/10.3341/kjo.2013.27.6.416

Abstract

PURPOSE
To analyze the autofluorescence (AF) properties of pinguecula using cobalt-blue and yellow filters and to investigate the nature and pathogenesis of pingueculae using histochemical and immunohistochemical staining.
METHODS
Fifty pingueculae in 40 patients were included in this study. AF of the pingueculae was observed and analyzed using a cobalt-blue filter with an additional yellow filter on a slit-lamp. Hematoxylin-eosin and immunohistochemical stainings were performed on surgical specimens of pingueculae that were prepared from each patient. Immunohistochemical staining included Congo red, Oil Red O, periodic acid-Schiff (PAS), Masson's trichrome, transglutaminase-2 (TG-2), mesenchymal stem cell markers CD29 (beta-1-integrin), and CD34.
RESULTS
AF images revealed hyper-AF in the pinguecula area. The AF lesions of pingueculae showed superficial punctuate erosions and avascular lesions. Deposition of eosinophilic and amorphous materials in the subepithelial layer of the pinguecula were observed on hematoxylin-eosin staining. Historeactivities to Congo red, PAS, Oil Red O, alcian blue, and Masson's trichrome were not detected, but immunoreactivities to CD29, CD34, and TG-2 were detected in the pingueculae with AF. However, CD29, CD34, and TG-2 were not detected in the pingueculae without AF.
CONCLUSIONS
The AF of pingueculae may be related to CD29, CD34, and TG-2. We suggest that pingueculae with AF have a different pathogenesis compared to pingueculae without AF.

Keyword

Optical imaging; Pinguecula; Transglutaminase 2

MeSH Terms

Aged
Coloring Agents/diagnostic use
Female
Fluorescence
Follow-Up Studies
Hematoxylin/*diagnostic use
Humans
Immunohistochemistry
Male
Microscopy, Confocal/*methods
Middle Aged
Pinguecula/*pathology
Retrospective Studies
Coloring Agents
Hematoxylin

Figure

• 

  Fig. 1 (A,B) Dilated tortous vessel, no vessel invasion and whitish deposits were seen in the pinguecula area. (C) Multiple erosions were observed in the area of pinguecula autofluorescence (AF). (D-F) Various images of pingueculae AF acquired using a cobalt blue filter with an additional yellow filter on a slit lamp biomicroscope.

• 

  Fig. 2 Immunohistochemical staining of pinguecula autofluorescence (AF). (A) Conjunctiva stroma with thinning of the overlying epithelium and calcification were detected. (B) Eosinophilic-stained amorphous material was detected in the subepithelial layer of the conjunctiva. (C-F) No immunoreactivity was detected. (G) Immunoreactivity to transglutaminase-2 was detected in the normal epithelium, normal vessel walls, and elastotic degeneration area of AF. (H,I) Immunoreactivity was detected. (A,B) Hematoxylin-eosin, (C) periodic acid-Schiff, (D) Masson's trichrome, (E) Congo red, (F) Oil Red O, (G) transglutaminase-2, (H) CD29 (β-1-integrin), and (I) CD 34 (×400).

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