{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:50:28Z","timestamp":1788871828241,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,3,21]],"date-time":"2014-03-21T00:00:00Z","timestamp":1395360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100011905","name":"Evald and Hilda Nissi Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100011905","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Finnish Eye and Tissue Bank Foundation"},{"name":"Helsinki University Central Funding"},{"name":"Mary and Georg C. Ehrnrooths Foundation"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      To refine the diagnostic criteria for peripheral hypertrophic subepithelial corneal degeneration (\n                      <jats:styled-content style=\"fixed-case\">PHSD<\/jats:styled-content>\n                      ) and characterize its clinical phenotype, histopathology and immunohistochemical features.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Diagnostic criteria were refined on the basis of literature data. Fourteen patients (13 women and one man; median age 52\u00a0years, range 33\u201366) were identified based on these criteria. Keratectomy specimens were evaluated via routine and immunohistochemical stainings. The main outcome measures were symptoms, clinical phenotype, immunological status and histopathologic results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We defined the diagnostic criteria of typical\n                      <jats:styled-content style=\"fixed-case\">PHSD<\/jats:styled-content>\n                      as elevated circumferential and perilimbal subepithelial fibrosis with focal superficial corneal neovascularization, which were supported by female sex (93%), bilaterality (86%), the centre being in the upper quadrants (81%) and irregular astigmatism of two dioptres or more. The typical symptoms were reduced vision (86%) and the symptoms of ocular surface disease (64%). Light microscopy showed fibrosis with abundant collagen deposition but no inflammation in all patients. An immunohistochemical analysis of nine patients showed uniform staining for vimentin in three distinct types of fibroblasts in variable proportions: keratocyte\u2010like cells that were positive for\n                      <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                      34, myofibroblasts that were positive for smooth muscle actin (\n                      <jats:styled-content style=\"fixed-case\">SMA<\/jats:styled-content>\n                      ) and fibroblasts that were negative for\n                      <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                      34 and\n                      <jats:styled-content style=\"fixed-case\">SMA<\/jats:styled-content>\n                      . Small numbers of\n                      <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                      68\u2010positive macrophages were also found.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Peripheral hypertrophic subepithelial degeneration is characteristic of middle\u2010aged women, in whom it is typically a bilateral idiopathic degeneration of the cornea associated with ocular surface disease and reduced vision. The fibrotic lesions probably undergo remodelling, inducing changes in corneal contour. A smouldering low\u2010grade inflammation favouring low\n                      <jats:styled-content style=\"fixed-case\">TGF<\/jats:styled-content>\n                      \u2010\n                      <jats:italic>\u03b2<\/jats:italic>\n                      1 concentrations is postulated as the primary pathological process leading to\n                      <jats:styled-content style=\"fixed-case\">PHSD<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aos.12394","type":"journal-article","created":{"date-parts":[[2014,3,21]],"date-time":"2014-03-21T05:44:48Z","timestamp":1395380688000},"page":"774-782","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Peripheral hypertrophic subepithelial corneal degeneration \u2013 clinical and histopathological features"],"prefix":"10.1111","volume":"92","author":[{"given":"Petri J.","family":"J\u00e4rventausta","sequence":"first","affiliation":[{"name":"Helsinki University Eye Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo M. T.","family":"Tervo","sequence":"additional","affiliation":[{"name":"Helsinki University Eye Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tero","family":"Kivel\u00e4","sequence":"additional","affiliation":[{"name":"Helsinki University Eye Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juha M.","family":"Holopainen","sequence":"additional","affiliation":[{"name":"Helsinki University Eye Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,3,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.06-0185"},{"key":"e_1_2_6_3_1","first-page":"S87","article-title":"Variations in the characteristics of keratocytes in culture in relation to their location in human cornea","volume":"18","author":"Builles N","year":"2008","journal-title":"Bio\u2010Med Mater Eng"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ico.0000153100.74033.ef"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.06-0968"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.04-0201"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ico.0000167879.88815.6b"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.10.037"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/aos.12029"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.icl.0000182875.61214.cf"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.02-0999"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.05-1040"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ico.0000183537.45393.1f"},{"key":"e_1_2_6_14_1","first-page":"2490","article-title":"Fibroblast growth factor reversal of the corneal myofibroblast phenotype","volume":"42","author":"Maltseva O","year":"2001","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.icl.0000087489.61955.82"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2006.097352"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2006.08.059"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/scd.2006.0084"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(02)01042-4"}],"container-title":["Acta Ophthalmologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faos.12394","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aos.12394","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T16:09:03Z","timestamp":1695485343000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aos.12394"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,3,21]]},"references-count":18,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2014,12]]}},"alternative-id":["10.1111\/aos.12394"],"URL":"https:\/\/doi.org\/10.1111\/aos.12394","archive":["Portico"],"relation":{},"ISSN":["1755-375X","1755-3768"],"issn-type":[{"value":"1755-375X","type":"print"},{"value":"1755-3768","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,3,21]]},"assertion":[{"value":"2013-10-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-02-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-03-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}