[Histopathology of herpetic corneal endotheliitis - a case report]

Clinically, corneal endotheliitis is characterized by endothelial cell edema associated with immune precipitates. It is supposed to be triggered by a humoral or cellular immunologic reaction against antigens of the corneal endothelium. As yet, only few histopathologic studies of this disease have been performed.

A 42-years-old patient developed a complete corneal nebula with neovascularizations due to relapsing herpetic keratitis. He underwent perforating keratoplasty. The inflammatory infiltrate lining Descemet's membrane and the corneal endothelium consisted mostly of CD 45 R0-positive T-lymphocytes with only few neutrophils, macrophages and CD 20-positive B-lymphocytes. We could not demonstrate any viral particles in the removed corneal tissue by either electron microscopy or using antibodies against Herpes simplex type I or II.

Histologically, herpetic endotheliitis appears to correspond to corneal endotheliitis due to graft rejection. Complete virus particles are not necessarily required in case of long-standing inflammation and corneal neovascularizations.