Epidemiology of Corneal Neovascularization and Its Impact on Visual Acuity and Sensitivity: A 14-Year Retrospective Study

Purpose: To quantify the severity and location of corneal neovascularization (cNV) and its impact on the visual acuity and corneal sensitivity in a cohort of the patients referred to a specialist cornea clinic and also to describe the etiology of cNV in the cohort.Methods: We retrospectively evaluated the charts of 13,493 subjects referred to the San Raffaele Cornea Unit between January 2004 and December 2018 to search for cNV diagnosis. The corneal neovascularization severity was measured in the quadrants (range: 1–4) and location was defined as superficial, deep, or both. Best spectacle corrected visual acuity (BSCVA) was measured in logMar. We used the multiple regression analysis to identify the independent predictors of logMAR, after adjusting for age, gender, keratoconus, herpes keratitis, penetrating keratoplasty, trauma, and cataract surgery.Results: Corneal neovascularization was diagnosed in 10.4% of the patients analyzed. The most prevalent etiology of cNV in our population was non-infectious corneal dystrophies/degenerations followed by herpes simplex virus infection. cNV affected OD, OS, or both eyes in 35.6, 40.2, and 24.2 of cases, respectively. Mean BSCVA (SD) was 0.59 (0.76), 0.74 (0.94), and 1.24 (1.08) in cNV one, two, and three or four of the quadrant groups. Superficial, deep, or mixed cNV occurred in 1,029, 348, and 205 eyes. Severe cNV (three or four of the quadrants) was a significant predictor of low visual acuity (p < 0.001) and reduced corneal sensitivity (p < 0.05). cNV location and its severity were associated (p < 0.05). In addition, corneal anesthesia was associated with lower BSCVA (p < 0.001).Conclusion: Severe and deep cNV are associated with the reduced visual acuity and corneal sensitivity. Our data strongly support the relevance of appropriate follow-up as cNV is a major risk factor for graft rejection.

HERPES ASSOCIATED ERITHEMA MULTIFORME (HAEM ) ON THE PSYCHOSOMATIC PATIENT : A CASE REPORT

Background : Erythema multiforme is an acute mucocutaneous inflammation which is self limiting desease. One of caused of Erythema multiforme is Herpes Simplex Virus infection diagnosed as Herpes Associated Erytema Multiforme (HAEM). The psychosomatic patients should be wary of anti-depressant therapy, because if there is an allergy, it can trigger the occurrence of erthema multiformis. In this paper, we will reported HAEM case on psychosomatic patient.Case and management : A case of 23 years old female patient with chief complaint sore and pain lips since one weeks ago. The patient has been on anti-depressant therapy for one month. Clinical examination on patient showed that there were erosive lesion covered by reddish brown crusta, sloughing on the border between lips and labial mucosa, and bloody lips. The results of laboratory tests show positive HSV. Patient was diagnosed with HAEM. Therapy given to the patient was corticosteroid topical oitment, acyclovir and oral rinse antiseptics. After two weeks the administration, condition on the patient has improved.Conclusions : HAEM cases if treated properly can recover well. Trigger factors must be controlled so that not recurrance