Concurrent macular corneal dystrophy and keratoconus

Abstract

A 21-year-old female presented with progressive bilateral visual loss for the past 8 years. The patient had no history of systemic disease, surgery or medications. Complete ophthalmologic examination and topography were performed. On ophthalmic examination, uncorrected visual acuity was counting fingers at 2.5 m (20/50 with pinhole) in the right and left eyes. Both corneas appeared hazy on gross examination. On slit-lamp biomicroscopy, focal grayish-white opacities with indistinct borders were noted in the superficial and deep corneal stroma of both eyes. Both corneas were thin and bulging. Corneal topography showed a pattern consistent with keratoconus. The patient underwent penetrating keratoplasty (PKP). Histopathologic studies after PKP confirmed the diagnosis of macular corneal dystrophy and keratoconus in the same eye. The patient was clinically diagnosed as a case of concurrent macular dystrophy and keratoconus, which is a very rare presentation.

Deep anterior lamellar keratoplasty and penetrating keratoplasty in macular corneal dystrophy: comparison of visual and topographic outcomes and complications

“…The cornea of MCD patients is typically thinner, leading to a significantly lower CV. While most patients with MCD do not exhibit corneal ectasia there are case studies in the literature that have linked keratoconus to MCD (16)(17)(18) . Both keratoconic and MCD corneas exhibit reduced keratan sulfate concentrations and an elevated dermatan to keratan sulfate ratio.…”

Detailed corneal and genetic characteristics of a pediatric patient with macular corneal dystrophy - case report

“…There are few case reports on the cooccurrence of keratoconus and MCD [ 37 , 38 ]. In the study of Dudakova et al, the authors observed anterior, paracentral steepening of the corneal surface, which was graded as keratoconus by Scheimflug integrated software, but without a coexisting ectasia pattern on the posterior corneal surface [ 28 ].…”