Contact lens induced bacterial keratitis in LCD II: Management and multimodal imaging: a case report and review of literature

2020 ◽  
pp. 112067212096872
Author(s):  
Munirah Alafaleq ◽  
Juliette Knoeri ◽  
Sandrine Boutboul ◽  
Vincent Borderie
Keyword(s):  
Contact Lens ◽  
Multimodal Imaging ◽  
Anterior Segment ◽  
Corneal Dystrophy ◽  
Bacterial Keratitis ◽  
Infectious Keratitis ◽  
Bandage Contact Lens ◽  
Lattice Corneal Dystrophy ◽  
Subepithelial Fibrosis

Purpose: To describe the management and multimodal imaging of lattice corneal dystrophy type II (LCD-II) complicated by an infectious keratitis due to a bandage contact lens and to review current literature. Observation: A 50-year-old female was diagnosed with Meretoja’s Syndrome by the triad of facial palsy, loose skin (cutix laxa), and stromal corneal dystrophy. At slit lamp, bilateral lattice corneal dystrophy (LCD) was characterized by multiple linear refractile lines and subepithelial fibrosis along with Neurotrophic keratitis Mackie grade I. Findings of anterior segment optical coherence tomography (AS-OCT) were epithelial irregularity, subepithelial fibrosis, hyperreflectivity on anterior stromal layer, lobulated stromal surface. In vivo confocal microscopy (IVCM) showed hyperreflected deposits on the basal and Bowman layers, visible keratocytes; fine lines and streaks between corneal lamella. The sub-basal nerve plexus and the stromal nerves were no longer visible. She presented in emergency with a left red eye. A severe bacterial keratitis was diagnosed as a complication of a bandage contact lens used to treat recurrent epithelial erosion. Corneal anesthesia was complete. Corneal neovascularization was evident 10 weeks later and topical bevacizumab (5 mg/ml) was introduced twice daily. Partial regression of deep stromal vessels was noticed at 3 months. Conclusion: In Meretoja’s syndrome, neurotrophic keratopathy secondary to polyneuropathy due to systemic amyloid deposits is present in the advanced stages, promotes recurrent corneal erosions. Corneal sensitivity test, AS-OCT and IVCM are crucial in the diagnosis behind any recurrent corneal erosion. The use of bandage contact lens should be avoided in Meretoja’s syndrome to prevent a possible infectious keratitis.

A novel missense TGFBI variant p.(Ser591Phe) in a Finnish family with variant lattice corneal dystrophy

2021 ◽  
pp. 112067212199730
Author(s):  
Aino Maaria Jaakkola ◽  
Petri J Järventausta ◽  
Reetta-Stiina Järvinen ◽  
Pauliina Repo ◽  
Tero T Kivelä ◽  
...  
Keyword(s):  
Transforming Growth Factor Beta ◽  
Transforming Growth Factor ◽  
Late Onset ◽  
Family Members ◽  
Anterior Segment ◽  
Corneal Dystrophy ◽  
Ophthalmological Examination ◽  
Lattice Corneal Dystrophy ◽  
Tgfbi Gene ◽  
Novel Variant

Introduction: We describe the phenotype of a variant lattice corneal dystrophy (LCD) potentially caused by a novel variant c.1772C>T p.(Ser591Phe) in exon 13 of the transforming growth factor beta-induced (TGFBI) gene. Case report: The proband, a 71-year-old woman referred because of bilateral LCD, first seen at the age of 65 years, with recent progressive symptoms, underwent a clinical ophthalmological examination, anterior segment optical coherence tomography and confocal microscopy. Additionally, three siblings and three children were examined. The identified TGFBI variant was screened in six family members using Sanger sequencing. A corneal dystrophy gene screen was performed for the proband. Translucent subepithelial irregularities and central to midperipheral stubby branching corneal stromal lattice lines, asymmetric between the right and the left eye, were visible and resulted in mild deterioration of vision in one eye. Genetic testing revealed a novel variant c.1772C>T in TGFBI, leading to the amino acid change p.(Ser591Phe). One daughter carried the same variant but had only thick stromal nerve fibres at the age of 49 years. The other family members neither had corneal abnormalities nor carried the variant. No keratoplasty is yet planned for the proband. Conclusions: We classify the novel variant in TGFBI as possibly pathogenic, potentially causing the late-onset, asymmetric variant LCD. Our findings add to the growing number of TGFBI variants associated with a spectrum of phenotypes of variant LCD.

Multimodal imaging of pre-Descemet corneal dystrophy

2019 ◽  
Vol 30 (5) ◽  
pp. 908-916 ◽  
Author(s):  
Munirah Alafaleq ◽  
Cristina Georgeon ◽  
Kate Grieve ◽  
Vincent M Borderie
Keyword(s):  
Optical Coherence Tomography ◽  
Confocal Microscopy ◽  
Multimodal Imaging ◽  
Case Series ◽  
Corneal Dystrophy ◽  
Spectral Domain ◽  
Optical Coherence ◽  
In Vivo Confocal Microscopy ◽  
Descemet Membrane

Purpose: The aim of this study was to assess structural and histological changes associated with pre-Descemet corneal dystrophy with multimodal in vivo imaging. Methods: Retrospective case series including eight corneas from four unrelated male patients with pre-Descemet corneal dystrophy characterized by the presence of punctiform gray opacities located just anterior to the Descemet membrane at slit-lamp examination of both eyes. In vivo confocal microscopy images were obtained in the central, paracentral, and peripheral corneal zones from the superficial epithelial cell layer down to the corneal endothelium in both eyes. Spectral domain optical coherence tomography scans (central and limbal zones) and mapping of both corneas were acquired. Results: Diffuse small extracellular stromal deposits, presence of enlarged hyperreflective keratocytes in the posterior stroma with either hyperreflective or hyporeflective intracellular dots, and presence of activated keratocytes in the very anterior stroma were observed in all corneas with in vivo confocal microscopy. Spectral domain optical coherence tomography scans showed a hyperreflective line anterior to Descemet’s membrane running from limbus to limbus and associated with a second thinner hyperreflective line just beneath Bowman’s layer. Fine hyperreflective particles were observed in the posterior, mid, and anterior stroma on optical coherence tomography scans. Conclusion: The clinical presentation and structural anomalies found in isolated sporadic pre-Descemet corneal dystrophy are in favor of a degenerative process affecting corneal keratocytes with no epithelial or endothelial involvement. The maximum damage is found just anterior to the Descemet membrane resulting in pre-Descemet membrane location of stromal opacities. Multimodal imaging of cornea reveals that the disorder affects the whole stroma and it permits better understanding of pre-Descemet corneal dystrophy pathophysiology together with ascertained diagnosis.

scholarly journals Multimodal Imaging and Histopathological Evaluation of Berger’s Space

2019 ◽  
Vol 6 (1) ◽  
pp. 3-9
Author(s):  
Virginia Mares ◽  
Marcio B. Nehemy ◽  
Diva R. Salomão ◽  
Shannon Goddard ◽  
Jaime Tesmer ◽  
...  
Keyword(s):  
Multimodal Imaging ◽  
Histological Study ◽  
Anterior Segment ◽  
Vitreous Hemorrhage ◽  
Slit Lamp ◽  
Anterior Segment Oct ◽  
Pathological Conditions ◽  
Actual Space ◽  
In Vivo Analysis

Objective: To demonstrate the multimodal imaging and histopathology of Berger’s space. Methods: We conducted a retrospective in vivo analysis of 4 patients demonstrating Berger’s space with intraocular pathological conditions, documented by slit-lamp biomicroscopic photography and, in 2 patients, also by optical coherence tomography (OCT). Additionally, we carried out a retrospective histological study of 7 enucleated eyes with retinoblastoma demonstrating Berger’s space. A review of the literature was also performed. Results: Two eyes had slit-lamp photographs. One case showed Berger’s space surrounded by vitreous hemorrhage. In the other case, amyloid was trapped within Berger’s space. In another 2 eyes that were pseudophakic, Berger’s space was visible on anterior segment OCT. One had amyloid trapped in Berger’s space that could be seen with OCT. The histological review of the 7 enucleated eyes with advanced retinoblastoma demonstrated the presence of pyknotic cells in Berger’s space. Conclusions: Berger’s space is an actual space in pathological conditions and can be an important site of pathology. Additionally, to our knowledge, this is the first time that Berger’s space has been documented by anterior segment OCT in a clinical setting.

scholarly journals Neurotropic Grades in Lattice Corneal Dystrophy Based on in Vivo Confocal Microscopy Observation

2020 ◽  
Author(s):  
ming li ◽  
Fengjiao Zhu ◽  
Chun Zhang ◽  
Chan Chen ◽  
Fangwei Ying ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Laser Scanning ◽  
Corneal Dystrophy ◽  
Amyloid Deposit ◽  
Laser Scanning Confocal Microscopy ◽  
Nerve Fibers ◽  
Scanning Confocal Microscopy ◽  
Lattice Corneal Dystrophy ◽  
Corneal Nerves

Abstract Background: To investigate the corneal neurotropic phenomenon in patients with lattice corneal dystrophy (LCD) with in vivo laser scanning confocal microscopy (IVCM). Methods: IVCM was performed on a total of 15 patients (28 eyes) with LCD annually at a follow-up. A collection of the data was acquired to be analyzed. Results: As indicated by the analysis, the LCD patients’ normal corneal stromal nerves (Grade 0) presented a decline with the prolongation of the follow-ups, corresponding to a gradual increase in grade I and II involving amyloid-wrapped nerve fibers, which demonstrated that the growing amount of amyloid deposit due to the corneal nerve invasion increased slowly over time. Conclusions: The neurotropic phenomenon could increase with its severity in the corneal lesion of the patients with LCD, and also reflect the distribution of the corneal nerves, to some extent. IVCM provides a rapid, noninvasive way to observe the corneal nerves, which can be an efficient means of better understanding the development of LCD.

scholarly journals In vivo confocal microscopy qualitative investigation of the relationships between lattice corneal dystrophy deposition and corneal nerves

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fengjiao Zhu ◽  
Ming Li ◽  
Chun Zhang ◽  
Chan Chen ◽  
Fangwei Ying ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Laser Scanning ◽  
Corneal Dystrophy ◽  
Amyloid Deposit ◽  
Laser Scanning Confocal Microscopy ◽  
Nerve Fibers ◽  
Scanning Confocal Microscopy ◽  
Lattice Corneal Dystrophy ◽  
Corneal Nerves

Abstract Background To investigate the corneal neurotropic phenomenon in patients with lattice corneal dystrophy (LCD) with in vivo laser scanning confocal microscopy (IVCM). Methods IVCM was performed on a total of 15 patients (28 eyes) with LCD annually at a follow-up. A collection of the data was acquired to be analyzed. Results As indicated by the analysis, the LCD patients’ normal corneal stromal nerves (Grade 0) presented a decline with the prolongation of the follow-ups, corresponding to a gradual increase in grade I and II involving amyloid-wrapped nerve fibers, which demonstrated that the growing amount of amyloid deposit due to the corneal nerve invasion increased slowly over time. Conclusions The neurotropic phenomenon could increase with its severity in the corneal lesion of the patients with LCD, and also reflect the distribution of the corneal nerves, to some extent. IVCM provides a rapid, noninvasive way to observe the corneal nerves, which can be an efficient means of better understanding the development of LCD.

Characteristics of Infectious Keratitis in Bandage Contact Lens Wear Patients

2019 ◽  
Vol 45 (6) ◽  
pp. 356-359 ◽  
Author(s):  
Binbin Zhu ◽  
Yunfang Liu ◽  
Lin Lin ◽  
Xiaodan Huang ◽  
Yue Zhang ◽  
...  
Keyword(s):  
Contact Lens ◽  
Infectious Keratitis ◽  
Contact Lens Wear ◽  
Bandage Contact Lens ◽  
Lens Wear

In vivo confocal microscopy and spectral domain anterior segment OCT in Lisch epithelial corneal dystrophy

2015 ◽  
Vol 38 (7) ◽  
pp. e151-e153 ◽  
Author(s):  
A. Rousseau ◽  
A. Labbé ◽  
C. Baudouin ◽  
I. Cochereau ◽  
E. Gabison ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Anterior Segment ◽  
Corneal Dystrophy ◽  
Spectral Domain ◽  
In Vivo Confocal Microscopy ◽  
Anterior Segment Oct

scholarly journals Multimodal Imaging Features of Schnyder Corneal Dystrophy

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Wassim Ghazal ◽  
Cristina Georgeon ◽  
Kate Grieve ◽  
Nacim Bouheraoua ◽  
Vincent Borderie
Keyword(s):  
Optical Coherence Tomography ◽  
Cross Sections ◽  
Multimodal Imaging ◽  
Corneal Dystrophy ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
En Face ◽  
Schnyder Corneal Dystrophy ◽  
Corneal Crystals

Objective. To describe the multimodal imaging of Schnyder corneal dystrophy. Methods. Seven eyes of seven patients (5 female and 2 male patients) aged 52 to 92 years were included in this prospective observational study. Diagnosis of SCD was confirmed by histology after keratoplasty. In vivo multimodal imaging consisted of spectral domain-optical coherence tomography with cross sections, en face scans, corneal pachymetry, and epithelial mapping, and in vivo confocal microscopy was recorded. Ex vivo full-field optical coherence tomography scans of two corneal buttons were analyzed. The seven corneal buttons obtained during penetrating or deep anterior lamellar keratoplasty were processed for light microscopy. Results. Slit-lamp examination showed central stromal opacities, arcus lipoides, and midperipheral haze. Corneal crystals were found in 2 out of 7 eyes. SD-OCT cross sections and en face scans showed diffuse hyperreflectivity of the anterior, mid, and posterior stroma with a maximum in the anterior stroma, hyporeflective stromal striae, and epithelial hyperreflectivity. Central corneal thickness ranged from 507 to 635 μm. IVCM revealed hyperreflective deposits in the epithelium and throughout the stroma, thin subepithelial nerves, and needle-shaped and rectangular crystals. Keratocyte nuclei were rare or undetectable. FF-OCT scans confirmed the presence of small round and needle-shaped hyperreflective deposits in the epithelium and stroma. Histology revealed vacuolization of the basal epithelial cells and empty interlamellar stromal vacuoles. Conclusion. High-resolution multimodal imaging demonstrates the characteristic features of SCD which involve both the corneal epithelium and stroma, and it provides diagnosis confirmation even in eyes with no visible corneal crystals at slit-lamp examination.

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