Histology of Thygeson’s Superficial Punctate Keratitis
Thygeson’s Superficial Punctate Keratitis, TSPK, or Thygeson’s Superficial Punctate Keratopathy has an unknown cause and this mystery has baffled the global medical community for over 60 years.
The histology of TSPK has shown that intracellular and intercellular edema at the epithelial level are commonly found in TSPK patients. Sixteen TSPK patients were inspected with a slit lamp and pictures were taken using photomicrography which is a no-contact process. The exhibits were then put side by side with morphology showing epithelial keratitis in herpes simplex type 1 (HSV1), VZV (varicella zoster), and Ad8 (adenovirus type XIII) infections. All of the comparisons were subject to a previous study conducted with identical methods and published as histological conclusions in TSPK.
The pictures showed the corneal epithelium contained different amounts of abnormal subsurface cells. The cells were 10-15mm round and showed up individually, small groupings, or stuck together to form a larger lesion. The surface epithelium was in good shape even though larger lesions did have debris on the surface. The morphology differed from HSV1 and VZV epithelial keratitis, yet looked very much like the epithelial modifications in Ad8 by day five of the test and kept the resemblance after the symptoms appeared.
Researchers concluded that TSPK might have a greater epithelial involvement than is suggested by the use of a slit lamp test. There is also an indication that some noxious substance that attacks deeper epithelial layers and that might explain the appearance of additional abnormal cells. The discussion then suggests that this picture may imply invading inflammatory cells are at work or the presence of damaged intraepithelial cells or even both. There is an undeniable comparison to Ad8 keratitis that leads some to believe a noxious substance source might exist outside the cornea.
The histology of Thygeson’s Superficial Punctate Keratitis is still under medical scrutiny as the global medical community continues to find a definitive cause or causes of TSPK.
Suggested Link: http://www.eur-j-ophthalmol.com/article/corneal-surface-changes-in-thygesons-superficial-punctate-keratitis–a-clinical-and-non-contact-photomicrographic-in-vivo-study-in-the-human-cornea-art002969 http://www.world-of-digitals.com/en/helena-m-tabery-adenovirus-epithelial-keratitis-and-thygeson-s-superficial-punctate-keratitis-ebook-pdf.html