2020–2021 BCSC Basic and Clinical Science Course™
4 Ophthalmic Pathology and Intraocular Tumors
Part I: Ophthalmic Pathology
Chapter 7: Anterior Chamber and Trabecular Meshwork
Degenerations
Iridocorneal Endothelial Syndrome
Iridocorneal endothelial (ICE) syndrome is a spectrum of acquired unilateral abnormalities of the corneal endothelium, anterior chamber angle, and iris. There are 3 recognized clinical variants of ICE (when combined, the first letter of each variant also forms the mnemonic ICE):
All forms of ICE syndrome, which typically affects young to middle-aged adults, have the following 2 features in common: epithelial-like metaplasia of the corneal endothelium and abnormal proliferation of the corneal endothelium. Abnormal endothelial cells migrate over the anterior chamber angle while laying down new basement membrane (Descemet membrane), leading to the formation of peripheral anterior synechiae (PAS) and subsequent secondary angle-closure glaucoma in approximately half of patients with this condition (Fig 7-7). See BCSC Section 8, External Disease and Cornea, and Section 10, Glaucoma, for further discussion.
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Silva L, Najafi A, Suwan Y, Teekhasaenee C, Ritch R. The iridocorneal endothelial syndrome. Surv Ophthalmol. 2018;63(5):665–676.
Excerpted from BCSC 2020-2021 series: Section 4 - Ophthalmic Pathology and Intraocular Tumors. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.