Histopathologic Characteristics in Blepharochalasis withBlepharoptosis
DOI:
https://doi.org/10.52547/50khyg31Keywords:
BlepharochalasisAbstract
Purose: To analyze the pathological and immunological findings in skin with orbicularis oculi
muscle as well as levator aponeurosis speicmens in blepharochalasis with blepharoptosis.
Methods: A prospective case-control study performed of 11 consecutive patients in
blepharochalasis with blepharoptosis was analyzed. All the samples obtained during surgery from
the department of Ophthalmology, Beijing Tongren Hospital between Jan. 2019 to Dec. 2022.
There were skin and orbicularis oculi muscle 10 cases, and levator aponeurosis 8 cases from
blepharochalasis
with
blepharoptosis.
Hematoxylin-eosin,
Van Gieson stains,
immunohistochemistry and colloidal gold-labeled pre-embedded indirect immunogold electron
microscopy (Gold-IIEM) were performed to analyze the characteristics of the samples. Normal
samples were obtained from the donors in the eye bank of Beijing Tongren Hospital as control
group.
Results: Hematoxylin-eosin and Van Gieson stains showed a marked loose and decrease of
collagen and elastic fibers of the upper eyelid. Muscles atrophy, derangement and rupture of
levator aponeurosis. The two experimental groups got a same result on immunohistochemical
staining that demonstrated a difference in level of immunoglobulin, including IgA, CD3+T cell
MMP-9 and type III collagen (P＜0.05).Gold-IIEM showed that a remarkable decrease of the density between collagenous fibers in the skin and orbicularis oculi muscle experimental group.
The mean gap between collagen fibers was 0.15±0.03μm in blepharochalasis group and
0.10±0.02μm in the control group. MMP-3 and MMP-9 colloidal gold existed in the basal
membrane cells and fibroblasts around the collagen.
Conclusions: The blepharoptosis in blepharochalasis appears abnormal histopathological changes
on skin and orbicularis oculi muscle as well as levator aponeurosis include perivascular
inflammatory cell infiltration, suggest that the immuno-pathogenetic mechanisms with the
involvement of cell-mediated immunoresponses might play a substantial role in the pathogenesis
of the disease.
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