Skip to main content
PMC home page
The American Journal of Pathology logoLink to The American Journal of Pathology
. 1972 May;67(2):327–348.

Chronic Actinic Keratopathy—A Condition Associated with Conjunctival Elastosis (Pingueculae) and Typified by Characteristic Extracellular Concretions

Gordon K Klintworth
PMCID: PMC2032607  PMID: 5021106

Abstract

Morphologic observations on a peculiar type of corneal reaction with a predisposition for the superficial stroma of the interpalpebral portion of the cornea are reviewed. Histochemical evidence is provided which indicates that the corneal concretions, though not homogenous, are proteinaceous in nature and contain amino acids not normally detectable in the cornea. The corneal concretions were associated with conjunctival elastosis (pingueculae) in all 22 instances in which the eyes were sectioned in the horizontal plane. Identical concretions were identified within these associated pingueculae, as well as in a large percentage of other pingueculae and cutaneous lesions with actinic elastosis. The findings suggest that the abnormal material arises in the pericorneal conjunctival connective tissue from whence it diffuses into, and deposits in, the superficial corneal stroma. The data also raise the possibility that the concretions may be derived, at least in part, from altered elastic tissue. Morphologic and epidemiologic observations on the condition taken together strongly suggest that this unique reaction is a sequel to the cumulative effect of chronic actinic irradiation. Further observations on this keratopathy are needed to establish whether this unique response can be provoked by other noxious stimuli.

Full text

PDF
327

Images in this article

345Fig 5
on p.345
345Fig 6
on p.345
345Fig 7
on p.345
345Fig 8
on p.345
346Fig 9
on p.346
346Fig 10
on p.346
347Fig 11
on p.347
347Fig 12
on p.347
343Fig 1
on p.343
343Fig 2
on p.343
343Fig 3
on p.343
343Fig 4
on p.343
348Fig 13
on p.348
348Fig 14
on p.348
348Fig 15
on p.348

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BIETTI G. B., GUERRA P., FERRARIS DE GASPARE P. F. La dystrophie cornéenne nodulaire en ceinture des pays tropicaux a sol aride; contributions cliniques et anatomo-pathologiques. Bull Mem Soc Fr Ophtalmol. 1955;68:101–129. [PubMed] [Google Scholar]
  2. COCKERELL E. G., FREEMAN R. G., KNOX J. M. Changes after prolonged exposure to sunlight. A study of factors influencing actinic degeneration. Arch Dermatol. 1961 Sep;84:467–472. doi: 10.1001/archderm.1961.01580150113018. [DOI] [PubMed] [Google Scholar]
  3. COHEN A. S., HASHIMOTO K. Electron microscopic observations on the lesion of elastosis perforans serpiginosa. J Invest Dermatol. 1960 Jul;35:15–19. [PubMed] [Google Scholar]
  4. DANE E. T., HERMAN D. L. Haematoxylin-phloxine-Alcian blue-orange G differential staining of prekeratin, keratin and mucin. Stain Technol. 1963 Mar;38:97–101. doi: 10.3109/10520296309061171. [DOI] [PubMed] [Google Scholar]
  5. Duke-Elder W. S., Duke-Elder P. M. A HISTOLOGICAL STUDY ON THE ACTION OF SHORT-WAVED LIGHT UPON THE EYE, WITH A NOTE ON "INCLUSION BODIES". Br J Ophthalmol. 1929 Jan;13(1):1–37. doi: 10.1136/bjo.13.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. FREEDMAN A. LABRADOR KERATOPATHY. Arch Ophthalmol. 1965 Aug;74:198–202. doi: 10.1001/archopht.1965.00970040200013. [DOI] [PubMed] [Google Scholar]
  7. GELLIN G. A., KOPF A. W., GARFINKEL L. BASAL CELL EPITHELIOMA. A CONTROLLED STUDY OF ASSOCIATED FACTORS. Arch Dermatol. 1965 Jan;91:38–45. doi: 10.1001/archderm.1965.01600070044004. [DOI] [PubMed] [Google Scholar]
  8. GILLMAN T., PENN J., BRONKS D., ROUX M. Abnormal elastic fibers; appearance in cutaneous carcinoma, irradiation injuries, and arterial and other degenerative connective tissue lesions in man. AMA Arch Pathol. 1955 Jun;59(6):733–749. [PubMed] [Google Scholar]
  9. Garner A. Keratinoid corneal degeneration. Br J Ophthalmol. 1970 Dec;54(12):769–780. doi: 10.1136/bjo.54.12.769. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Greenlee T. K., Jr, Ross R., Hartman J. L. The fine structure of elastic fibers. J Cell Biol. 1966 Jul;30(1):59–71. doi: 10.1083/jcb.30.1.59. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hogan M. J., Alvarado J. Pterygium and pinguecula: electron microscopic study. Arch Ophthalmol. 1967 Aug;78(2):174–186. doi: 10.1001/archopht.1967.00980030176010. [DOI] [PubMed] [Google Scholar]
  12. KOZŁOWSKI B. Szczególna postać zwyrodnienia szklistego rogówki. Klin Oczna. 1953;23(4):239–253. [PubMed] [Google Scholar]
  13. LUND H. Z., SOMMERVILLE R. L. Basophilic degeneration of the cutis; data substantiating its relation to prolonged solar exposure. Am J Clin Pathol. 1957 Feb;27(2):183–190. doi: 10.1093/ajcp/27.2.183. [DOI] [PubMed] [Google Scholar]
  14. MERCER E. H., ROGERS G. E., MUNGER B. L., ROTH S. I. A SUGGESTED NOMENCLATURE FOR FINE-STRUCTURAL COMPONENTS OF KERATIN AND KERATIN-LIKE PRODUCTS OF CELLS. Nature. 1964 Jan 25;201:367–368. doi: 10.1038/201367a0. [DOI] [PubMed] [Google Scholar]
  15. REYNOLDS E. S. The use of lead citrate at high pH as an electron-opaque stain in electron microscopy. J Cell Biol. 1963 Apr;17:208–212. doi: 10.1083/jcb.17.1.208. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Ross R., Bornstein P. Elastic fibers in the body. Sci Am. 1971 Jun;224(6):44–52. doi: 10.1038/scientificamerican0671-44. [DOI] [PubMed] [Google Scholar]
  17. Ross R., Bornstein P. The elastic fiber. I. The separation and partial characterization of its macromolecular components. J Cell Biol. 1969 Feb;40(2):366–381. doi: 10.1083/jcb.40.2.366. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. SAMS W. M., Jr, SMITH J. G., Jr, BURK P. G. THE EXPERIMENTAL PRODUCTION OF ELASTOSIS WITH ULTRAVIOLET LIGHT. J Invest Dermatol. 1964 Dec;43:467–471. [PubMed] [Google Scholar]
  19. SAMS W. M., Jr, SMITH J. G., Jr The histochemistry of chronically sun-damaged skin. An investigation of mucopolysaccharides and basophilia in actinically damaged skin using alcian blue, mowry's, and Hicks-Matthaei stains, methylation, and saponification. J Invest Dermatol. 1961 Nov;37:447–453. doi: 10.1038/jid.1961.141. [DOI] [PubMed] [Google Scholar]
  20. SUGAR H. S., KOBERNICK S. The white limbus girdle of Vogt. Am J Ophthalmol. 1960 Jul;50:101–107. doi: 10.1016/0002-9394(60)90843-6. [DOI] [PubMed] [Google Scholar]
  21. THOMAS J., ELSDEN D. F., PARTRIDGE S. M. PARTIAL STRUCTURE OF TWO MAJOR DEGRADATION PRODUCTS FROM THE CROSS-LINKAGES IN ELASTIN. Nature. 1963 Nov 16;200:651–652. doi: 10.1038/200651a0. [DOI] [PubMed] [Google Scholar]
  22. TZITSIKAS H., RDZOK E. J., VATTER A. E. Staining procedures for ultrathin sections of tissues embedded in polyester resin. Stain Technol. 1961 Nov;36:355–359. doi: 10.3109/10520296109113310. [DOI] [PubMed] [Google Scholar]
  23. VASSAR P. S., CULLING C. F. Fluorescent stains, with special reference to amyloid and connective tissues. Arch Pathol. 1959 Nov;68:487–498. [PubMed] [Google Scholar]
  24. Volpi U., Serra A. Contributo alla conoscenza della degenerazione sferulare elaioidea della cornea. Ann Ottalmol Clin Ocul. 1967 Dec;93(12):1305–1310. [PubMed] [Google Scholar]

Articles from The American Journal of Pathology are provided here courtesy of American Society for Investigative Pathology

RESOURCES