Purpose: To investigate the transmission electron microscopic findings of lens epithelial cells (LECs) in patients with different subtypes of uveitis and to compare the findings with those in age-matched controls. Methods: In this prospective case-control study, the anterior lens capsules were taken from 47 eyes of 47 patients with uveitis of different subtypes (17 with Fuchs uveitis syndrome [FUS], 13 with ­Behçet’s uveitis, 10 with idiopathic uveitis, and 7 with herpetic keratouveitis) and from 15 eyes of 15 control patients. Results: In the FUS group, the LECs had homogeneous thickening and irregularity, with some small vacuoles and widespread, oval-shaped pigment clusters in some areas. In the Behçet uveitis group, there was evident thinning in the lens epithelium. The subepithelial tissue under the epithelium was thickened, and edematous areas were detected. In the idiopathic uveitis group, the LECs were thinner with small vacuoles, and the cubic structure of the LECs was transformed into a squamous one. Moreover, the LECs included some small vacuoles, similar to those in the FUS group. In the herpetic keratouveitis group, two prominent cell types were observed: (1) completely normal LECs and (2) degenerated-type LECs with pyknotic nuclei, condensation of chromatin, swelling in the cytoplasm, membrane ruptures, and intra­cytoplasmic inclusion bodies. In the control group, the LECs and all of their elements occurred in normal ultrastructural patterns, with the exception of a few small intraepithelial vacuoles, which were fewer in number and smaller than those in the FUS and idiopathic uveitis groups. Conclusion: The electron microscopic analysis of LECs of patients with different subtypes of uveitis revealed significant ultrastructural alterations, which may be related to the summation of oxidative stress and intraocular inflammation.

1.
Van Gelder
RN
,
Leveque
TK
.
Cataract surgery in the setting of uveitis
.
Curr Opin Ophthalmol
.
2009
Jan
;
20
(
1
):
42
5
.
[PubMed]
1040-8738
2.
Zhang
Y
,
Zhu
X
,
He
W
,
Jiang
Y
,
Lu
Y
.
Efficacy of cataract surgery in patients with uveitis: A STROBE-compliant article
.
Medicine (Baltimore)
.
2017
Jul
;
96
(
30
):
e7353
.
[PubMed]
0025-7974
3.
Jancevski
M
,
Foster
CS
.
Cataracts and uveitis
.
Curr Opin Ophthalmol
.
2010
Jan
;
21
(
1
):
10
4
.
[PubMed]
1040-8738
4.
Michael
R
,
Bron
AJ
.
The ageing lens and cataract: a model of normal and pathological ageing
.
Philos Trans R Soc Lond B Biol Sci
.
2011
Apr
;
366
(
1568
):
1278
92
.
[PubMed]
0962-8436
5.
Danysh
BP
,
Duncan
MK
.
The lens capsule
.
Exp Eye Res
.
2009
Feb
;
88
(
2
):
151
64
.
[PubMed]
0014-4835
6.
Bhat
SP
.
The ocular lens epithelium
.
Biosci Rep
.
2001
Aug
;
21
(
4
):
537
63
.
[PubMed]
0144-8463
7.
Andjelic
S
,
Drašlar
K
,
Hvala
A
,
Lopic
N
,
Strancar
J
,
Hawlina
M
.
Anterior lens epithelial cells attachment to the basal lamina
.
Acta Ophthalmol
.
2016
May
;
94
(
3
):
e183
8
.
[PubMed]
1755-375X
8.
Spector
A
.
Oxidative stress-induced cataract: mechanism of action
.
FASEB J
.
1995
Sep
;
9
(
12
):
1173
82
.
[PubMed]
0892-6638
9.
Truscott
RJ
.
Age-related nuclear cataract-oxidation is the key
.
Exp Eye Res
.
2005
May
;
80
(
5
):
709
25
.
[PubMed]
0014-4835
10.
Tekin
K
,
Erol
YO
,
Inanc
M
,
Sargon
MF
,
Can
CU
,
Polat
S
, et al
.
Electron microscopic evaluation of anterior lens epithelium in patients with idiopathic congenital cataract
.
Int Ophthalmol
.
2018
Oct
;
38
(
5
):
2127
32
.
[PubMed]
0165-5701
11.
Straatsma
BR
,
Lightfoot
DO
,
Barke
RM
,
Horwitz
J
.
Lens capsule and epithelium in age-related cataract
.
Am J Ophthalmol
.
1991
Sep
;
112
(
3
):
283
96
.
[PubMed]
0002-9394
12.
Andjelic
S
,
Drašlar
K
,
Hvala
A
,
Hawlina
M
.
Anterior lens epithelium in intumescent white cataracts - scanning and transmission electron microscopy study
.
Graefes Arch Clin Exp Ophthalmol
.
2016
Feb
;
254
(
2
):
269
76
.
[PubMed]
0721-832X
13.
Inanc
M
,
Tekin
K
,
Erol
YO
,
Sargon
MF
,
Koc
M
,
Budakoglu
O
, et al
.
The ultrastructural alterations in the lens capsule and epithelium in eyes with traumatic white cataract
.
Int Ophthalmol
.
2019
Jan
;
39
(
1
):
47
53
.
[PubMed]
0165-5701
14.
Jabs
DA
,
Nussenblatt
RB
,
Rosenbaum
JT
;
Standardization of Uveitis Nomenclature (SUN) Working Group
.
Standardization for reporting clinical data: results of the First International Workshop
.
Am J Ophthalmol
.
2005
;
140
(
3
):
509
16
.
[PubMed]
0002-9394
15.
Mohamed
Q
,
Zamir
E
.
Update on Fuchs’ uveitis syndrome
.
Curr Opin Ophthalmol
.
2005
Dec
;
16
(
6
):
356
63
.
[PubMed]
1040-8738
16.
Suzuki Kurokawa
M
,
Suzuki
N
.
Behcet’s disease
.
Clin Exp Med
.
2004
Sep
;
4
(
1
):
10
20
.
[PubMed]
1591-8890
17.
International Study Group for Behçet’s Disease
.
Criteria for diagnosis of Behçet’s disease
.
Lancet
.
1990
May
;
335
(
8697
):
1078
80
.
[PubMed]
0140-6736
18.
Nalcacioglu-Yüksekkaya
P
,
Ozdal
PC
,
Teke
MY
,
Kara
C
,
Ozturk
F
.
Presumed herpetic anterior uveitis: a study with retrospective analysis of 79 cases
.
Eur J Ophthalmol
.
2014
Jan-Feb
;
24
(
1
):
14
20
.
[PubMed]
1120-6721
19.
Hawlina
M
,
Stunf
S
,
Hvala
A
.
Ultrastructure of anterior lens capsule of intumescent white cataract
.
Acta Ophthalmol
.
2011
Jun
;
89
(
4
):
e367
70
.
[PubMed]
1755-375X
20.
Singh
AJ
,
Sarodia
UA
,
Brown
L
,
Jagjivan
R
,
Sampath
R
.
A histological analysis of lens capsules stained with trypan blue for capsulorrhexis in phacoemulsification cataract surgery
.
Eye (Lond)
.
2003
Jul
;
17
(
5
):
567
70
.
[PubMed]
0950-222X
21.
Rojas
B
,
Zafirakis
P
,
Foster
CS
.
Cataract surgery in patients with uveitis
.
Curr Opin Ophthalmol
.
1997
Feb
;
8
(
1
):
6
12
.
[PubMed]
1040-8738
22.
Foster
CS
,
Rashid
S
.
Management of coincident cataract and uveitis
.
Curr Opin Ophthalmol
.
2003
Feb
;
14
(
1
):
1
6
.
[PubMed]
1040-8738
23.
Okhravi
N
,
Towler
HM
,
Lightman
SL
.
Cataract surgery in patients with uveitis
.
Eye (Lond)
.
2000
Oct
;
14
(
Pt 5
):
689
90
.
[PubMed]
0950-222X
24.
Ooi
KG
,
Galatowicz
G
,
Calder
VL
,
Lightman
SL
.
Cytokines and chemokines in uveitis: is there a correlation with clinical phenotype
.
Clin Med Res
.
2006
Dec
;
4
(
4
):
294
309
.
[PubMed]
1539-4182
25.
Zierhut
M
,
Pavesio
C
,
Ohno
S
,
Orefice
F
,
Rao
NA
. Cataract.
Intraocular inflammation textbook
.
Springer
;
2016
. pp.
419
41
.
26.
Rao
NA
,
Romero
JL
,
Fernandez
MA
,
Sevanian
A
,
Marak
GE
Jr
.
Role of free radicals in uveitis
.
Surv Ophthalmol
.
1987
Nov-Dec
;
32
(
3
):
209
13
.
[PubMed]
0039-6257
27.
Hightower
KR
.
The role of the lens epithelium in development of UV cataract
.
Curr Eye Res
.
1995
Jan
;
14
(
1
):
71
8
.
[PubMed]
0271-3683
28.
Parmigiani
CM
,
McAvoy
JW
.
The roles of laminin and fibronectin in the development of the lens capsule
.
Curr Eye Res
.
1991
Jun
;
10
(
6
):
501
11
.
[PubMed]
0271-3683
29.
Krag
S
,
Andreassen
TT
.
Mechanical properties of the human lens capsule
.
Prog Retin Eye Res
.
2003
Nov
;
22
(
6
):
749
67
.
[PubMed]
1350-9462
30.
Andley
UP
.
The lens epithelium: focus on the expression and function of the alpha-crystallin chaperones
.
Int J Biochem Cell Biol
.
2008
;
40
(
3
):
317
23
.
[PubMed]
1357-2725
31.
Meyer
LM
,
Wegener
AR
,
Holz
FG
,
Kronschläger
M
,
Bergmanson
JP
,
Soderberg
PG
.
Ultrastructure of UVR-B-induced cataract and repair visualized with electron microscopy
.
Acta Ophthalmol
.
2014
Nov
;
92
(
7
):
635
43
.
[PubMed]
1755-375X
32.
Joo
CK
,
Lee
EH
,
Kim
JC
,
Kim
YH
,
Lee
JH
,
Kim
JT
, et al
.
Degeneration and transdifferentiation of human lens epithelial cells in nuclear and anterior polar cataracts
.
J Cataract Refract Surg
.
1999
May
;
25
(
5
):
652
8
.
[PubMed]
0886-3350
33.
Synder
A
,
Omulecka
A
,
Ratyńska
M
,
Omulecki
W
.
[A study of human lens epithelial cells by light and electron microscopy and by immunohistochemistry in different types of cataracts]
.
Klin Oczna
.
2002
;
104
(
5-6
):
369
73
.
[PubMed]
0023-2157
34.
Seland
JH
.
The ultrastructure of the human lens capsule. II. Cataracta complicata. A transmission electron microscopic study
.
Acta Ophthalmol (Copenh)
.
1978
Oct
;
56
(
5
):
723
34
.
[PubMed]
0001-639X
35.
Stunf
S
,
Hvala
A
,
Vidovič Valentinčič
N
,
Kraut
A
,
Hawlina
M
.
Ultrastructure of the anterior lens capsule and epithelium in cataracts associated with uveitis
.
Ophthalmic Res
.
2012
;
48
(
1
):
12
21
.
[PubMed]
0030-3747
36.
Tugal-Tutkun
I
,
Güney-Tefekli
E
,
Kamaci-Duman
F
,
Corum
I
.
A cross-sectional and longitudinal study of Fuchs uveitis syndrome in Turkish patients
.
Am J Ophthalmol
.
2009
Oct
;
148
(
4
):
510
515.e1
.
[PubMed]
0002-9394
37.
Jones
NP
.
Fuchs’ Heterochromic Uveitis: a reappraisal of the clinical spectrum
.
Eye (Lond)
.
1991
;
5
(
Pt 6
):
649
61
.
[PubMed]
0950-222X
38.
Yang
P
,
Fang
W
,
Jin
H
,
Li
B
,
Chen
X
,
Kijlstra
A
.
Clinical features of Chinese patients with Fuchs’ syndrome
.
Ophthalmology
.
2006
Mar
;
113
(
3
):
473
80
.
[PubMed]
0161-6420
39.
Norrsell
K
,
Sjödell
L
.
Fuchs’ heterochromic uveitis: a longitudinal clinical study
.
Acta Ophthalmol
.
2008
Feb
;
86
(
1
):
58
64
.
[PubMed]
1755-375X
40.
Melamed
S
,
Lahav
M
,
Sandbank
U
,
Yassur
Y
,
Ben-Sira
I
.
Fuch’s heterochromic iridocyclitis: an electron microscopic study of the iris
.
Invest Ophthalmol Vis Sci
.
1978
Dec
;
17
(
12
):
1193
9
.
[PubMed]
0146-0404
41.
McCartney
AC
,
Bull
TB
,
Spalton
DJ
.
Fuchs’ heterochromic cyclitis: an electron microscopy study
.
Trans Ophthalmol Soc U K
.
1986
;
105
(
Pt 3
):
324
9
.
[PubMed]
0078-5334
42.
Tinari
A
,
Giammarioli
AM
,
Manganelli
V
,
Ciarlo
L
,
Malorni
W
.
Analyzing morphological and ultrastructural features in cell death
.
Methods Enzymol
.
2008
;
442
:
1
26
.
[PubMed]
0076-6879
43.
Burattini
S
,
Falcieri
E
.
Analysis of cell death by electron microscopy
.
Methods Mol Biol
.
2013
;
1004
:
77
89
.
[PubMed]
1064-3745
44.
Balanchander
N
,
Rajesh
E
,
Priya
S
,
Masthan
KM
.
Inclusion bodies
.
Biomed Pharmacol J
.
2016
;
9
(
2
): 0974-6242
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