León RY, Hernández FY, Pérez PZ, Jareño OM, Moreno RM, Casas AX

Language: Spanish
References: 16
Page: 1-9
PDF size: 299.34 Kb.

ABSTRACT

Corneal dystrophies are a group of hereditary diseases often bilateral and symmetrical which progress slowly and without any relationship to environmental or systemic factors. A case is presented of a white 45-year-old female patient referred to the Cornea Service of Ramón Pando Ferrer Cuban Institute of Ophthalmology, who reported a foreign body sensation, light sensitivity and poor vision in both eyes, as well as a history of hexagonal keratotomy from approximately 20 years before. Slit lamp examination revealed numerous punctiform lesions in the form of clear blister-like vesicles distributed paracentrally and slightly sparing the center, with transparent cornea spaces between them and better visibility of the lesions under retroillumination. Confocal microscopy showed round or oval cystic and hyporeflective structures in the right eye, whereas the left eye exhibited diffuse hyperreflective images in the basal corneal epithelium. Tortuous corneal nerves of a fragmented appearance were detected in both eyes. A Meesmann dystrophy diagnosis was considered and superficial keratectomy was performed, with which the patient's symptoms were relieved.

REFERENCES

1. Weiss JS, Møller HU, Aldave AJ, Seitz B, Bredrup C, Kivelä T, et al. The IC3D classification of the corneal dystrophies –edition 2. Cornea. 2015;34(2):117-59.

2. American Academy of Ophthalmology. External diseases and cornea. Basic and Clinical Sciences Course. San Francisco, CA: American Academy of Ophthalmology; 2017.

3. Ridgway A, Akhtar S, Munier F. El análisis ultraestructural y molecular de las distrofias corneales capa de Bowman: un origen epitelial? Invertir Ophthalmol Vis Sci. 2000; 41:3248- 92.

4. Kannabiran C, Klintworth G. Las mutaciones genéticas TGFBI en distrofias corneales. La mutación humana. 2006;27:615-25.

5. Tuft S, Bron A J. Imaging the microstructural abnormalities of Meesmann coneal dystrophy by in vivo confocal microscopy. Cornea. 2006;25(7):868-70.

6. Cantor LB, Rapuano CJ, Cioffi GA. Corneal Dystrophies and Ectasias. En: American Academy of Ophthalmology. Copyright; 2016.p. 267-304.

7. Jalbert I, Stapleton F. Gestión de la Distrofia Meesmann sintomático. Optom Vis Sci. 2009.

8. Barraquer RI, Toledo MC, Torres E. Distrofias y degeneraciones corneales. Barcelona: Espaxs; 2004.

9. Benitez Menino MC, Capote Cabrera A, Rio Torres M, Hernandez Silva JR. Microscopia confocal de la córnea Ilustraciones. La Habana: Editorial ciencias Médicas; 2013.

10. Javadi M, Rezaei-Kanavi M, Javadi A, Naghshgar N. Meesmann Corneal Dystrophy; a Clinico-Pathologic, Ultrastructural and Confocal Scan Report. Journal of ophthalmic and Vision Researchj. 2010;5 (2):122-6.

11. Cao W, Yan M, Yun Q, Wang S, Wu L. Autosomal-dominant Meesmann epithelial corneal dystrophy without an exon mutation in the keratin-3 or keratin-12 gene in a Chinese family. Journal of International Medical Research. 2013;41(2):511-8.

12. Patel DV, Grupcheva CN, McGhee CN. Imaging the microstructural abnormalities of Meesmann corneal dystrophy by in vivo confocal microscopy. Cornea 2005;24:669-73.

13. Tsubasa N, Akira K, Natsuko M, Toshinori M, Hideaki. In vivo histology and p.L132V mutation in KRT12 gene in Japanese patients with Meesmann corneal dystrophy. Japanese Journal of Ophthalmology. 2019;63(1):46-55.

14. Shukla AN, Cruzat A, Hamrah P. Confocal Microscopy of Corneal Dystrophies. 15. Semin Ophthalmol. 2012;27(0): 107-16.

15. Stocker FW, Holt LB. A rare form of hereditary epithelial dystrophy of the cornea: a genetic, clinical and pathologic study. Trans Am Ophthalmol Soc. 1954;52:133-44.

16. Boyd S. Distrofias y degeneraciones corneales. Panamá: Highlights Medical Publishers; 2012.