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Electron microscopical study of the Fleisher ring

T Iwamoto, A G DeVoe

    Archives of Ophthalmology (Chicago, Ill. : 1960)
    |September 1, 1976
    PubMed
    Summary
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    The Fleischer ring in keratoconus involves ferritin particle accumulation in corneal epithelium. These iron deposits were observed in intercellular spaces and vacuoles, offering insights into keratoconus pathogenesis.

    Area of Science:

    • Ophthalmology
    • Electron Microscopy
    • Corneal Diseases

    Background:

    • The Fleischer ring is a characteristic sign observed in keratoconus, an ectatic corneal disorder.
    • The precise composition and origin of the Fleischer ring have been areas of ongoing research.
    • Understanding the ultrastructural basis of the Fleischer ring may provide insights into keratoconus pathology.

    Purpose of the Study:

    • To investigate the ultrastructural characteristics of the Fleischer ring in keratoconus using transmission electron microscopy.
    • To identify the location and nature of ferritin particle accumulations within the cornea.
    • To compare findings in keratoconus with normal human corneal and conjunctival tissues.

    Main Methods:

    • Transmission electron microscopy (TEM) was employed to examine four corneal buttons from patients with keratoconus.

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  • Normal human corneas and conjunctivas were also analyzed using TEM for comparative purposes.
  • Detailed ultrastructural analysis focused on identifying and localizing ferritin particles.
  • Main Results:

    • Accumulations of ferritin particles were identified in widened intercellular spaces and cytoplasmic vacuoles of the corneal epithelium in keratoconus.
    • These ferritin deposits were predominantly found in the basal epithelial layers, with some observed in wing cell layers.
    • Ferritin particles were also noted scattered over the corneal epithelium, in basal conjunctival cells, and within macrophages in the conjunctival stroma, but not in corneal stroma or endothelium.

    Conclusions:

    • The Fleischer ring in keratoconus is characterized by the deposition of ferritin particles within the corneal epithelium.
    • The presence of ferritin in various corneal and conjunctival cell types suggests a complex deposition process.
    • Further research is warranted to elucidate the exact origin and pathogenic role of these ferritin deposits in keratoconus.