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Overhanging-Dissecting Blebs: Immunohistochemical Characterization.

Ali S Al-Beshri1, Deepak P Edward1,2,3, Khitam Al Haiti1

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Summary
This summary is machine-generated.

Glaucoma filtering blebs migrating under the cornea epithelium were identified using histopathology. This suggests dissecting blebs originate beneath the corneal epithelium, not over it.

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Area of Science:

  • Ophthalmology
  • Histopathology
  • Immunohistochemistry

Background:

  • Glaucoma filtering surgery creates blebs, which can migrate.
  • The epithelial origin and matrix of these blebs are not fully understood.

Purpose of the Study:

  • To determine if glaucoma filtering blebs migrate over or under the cornea epithelium.
  • To evaluate the origin of the surface epithelium and bleb matrix using histopathologic and immunohistochemical techniques.

Main Methods:

  • Histologic and immunohistochemical evaluations of normal conjunctiva, corneal overhanging-dissecting blebs, and leaking blebs.
  • Antibodies against epithelial (cytokeratin 3 (CK3)+12, CK13) and extracellular matrix (decorin, keratan sulfate (KS)) antigens were used.
  • Labeling was graded semiquantitatively.

Main Results:

  • Epithelium of dissecting blebs showed labeling primarily with CK3+12 antibody, indicating a corneal epithelial phenotype.
  • Keratan sulfate (KS) staining was faint and comparable across normal conjunctiva, dissecting blebs, and leaking blebs.
  • Decorin staining intensity in dissecting blebs was comparable to normal conjunctival stroma and significantly greater than in leaking blebs.

Conclusions:

  • Histology and immunohistochemistry suggest dissecting blebs possess a corneal epithelial phenotype.
  • The extracellular matrix immunophenotype of dissecting blebs resembles normal conjunctival stroma.
  • Findings indicate that dissecting blebs likely migrate under the corneal epithelium.