Correlation Between Clinical In Vivo Confocal Microscopic and Ex Vivo Histopathologic Findings of Salzmann Nodular Degeneration

Meltendorf, Christian; Bühren, Jens; Bug, R.; Ohrloff, C.; Kohnen, T

doi:10.1097/01.ico.0000214215.75496.a5

Cited by 25 publications

(32 citation statements)

References 14 publications

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“…Within the entire follow-up period up to 31 months, we did not experience any complications and epithelial healing seemed to be normal. Our findings after treatment correspond well with findings of SND by other authors in earlier literature [13].…”

Section: Discussionsupporting

confidence: 95%

“…The first report on the use of topical MMC for the treatment of patients with recurrent, visually disabling subepithelial fibrosis after radial keratotomy (RK) and photorefractive keratectomy (PRK) was by Majmudar et al [10] in 2000. Meanwhile, MMC in combination with PTK was also described by other authors [13,19,20].…”

Section: Introductionmentioning

confidence: 80%

“…In vivo confocal microscopy enhanced the assessment by showing microstructural alterations. Nevertheless, the diagnosis of SND is primarily a clinical one because there is no pathognomonic finding by confocal microscopy [13].…”

Section: Patientsmentioning

confidence: 99%

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Superficial keratectomy, PTK, and mitomycin C as a combined treatment option for Salzmann's nodular degeneration: a follow-up of eight eyes

Khaireddin

Katz

Baile³

et al. 2011

Graefes Arch Clin Exp Ophthalmol

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Our follow-up and the small treatment numbers are not sufficient to finally prove the superiority of the combined treatment modality (superficial keratectomy, PTK, and MMC) for SND, but the results of our study are promising. Longer follow-up and a larger cohort are warranted for proving MMC to be an effective, successful, and safe method in the armamentarium for treating and preventing Salzmann degeneration.

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Section: Discussionsupporting

confidence: 95%

Section: Introductionmentioning

confidence: 80%

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Superficial keratectomy, PTK, and mitomycin C as a combined treatment option for Salzmann's nodular degeneration: a follow-up of eight eyes

Khaireddin

Katz

Baile³

et al. 2011

Graefes Arch Clin Exp Ophthalmol

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“…The new modalities of in vivo imaging are transforming the need for histopathologic correlation. Meltendorf et al 6 have demonstrated comparable findings for Salzmann nodular degeneration between histopathology and in vivo confocal microscopy. Classical histopathologic findings of Salzmann nodular degeneration have been described as an accumulation of a dense basement membrane-like material overlying stromal disorganization that obliterates Bowman layer and is covered by a thinned layer of epithelium.…”

Section: Discussionmentioning

confidence: 62%

Bilateral Salzmann-like nodular corneal degeneration after laser in situ keratomileusis imaged with anterior segment optical coherence tomography and high-frequency ultrasound biomicroscopy

VanderBeek¹,

Silverman²,

Starr³

2009

Journal of Cataract and Refractive Surgery

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Examination of a 34-year-old patient 7 years after laser in situ keratomileusis (LASIK) showed Salzmann-like nodules in both eyes, causing irregular astigmatism and decreased visual acuity. Two new imaging modalities were used to demonstrate the characteristics of this complication. Anterior segment optical coherence tomography (OCT) (Visante) scans showed hyperreflective nodules that varied in thickness from 0.35 mm to 0.56 mm. High-frequency ultrasound biomicroscopy illustrated the destruction of Bowman layer underlying these lesions. Both modalities demonstrated nodules as hyperreflective material covered by an abnormally thin layer of epithelium. Salzmann-like nodular degeneration is a rare but possible cause of decreased visual acuity and irregular astigmatism after LASIK surgery. Ultrasound biomicroscopy and OCT can demonstrate many of the established histopathologic findings in vivo.

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“…Das Epithel über den Knötchen ist verdünnt und verändert [28,38,45,49]. Die Auflösung der ursprünglichen Bowman und ihren Ersatz durch pathologisches Dystrophiegewebe hatte Salzmann fehlinterpretiert als einen Prozess, der durch einen resorptiven, entzündlichen Pannus verursacht worden sei.…”

Section: Histopathologische Einordnung Der Salzmann-dystrophie Bei Deunclassified

Salzmannsche noduläre Hornhautdegeneration

Sundmacher

2012

Ophthalmologe

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So-called Salzmann's nodular degeneration has been given a misleading position in the systematics of ophthalmology. The majority of cases of Salzmann's nodular degeneration are in fact a clinical entity fulfilling the criteria of epithelial corneal dystrophy involving Bowman's layer. As with all epithelial dystrophies Salzmann's nodular degeneration recurs after surgical removal. An analysis of Salzmann's original paper discloses that the etiological postulates (severe preceding keratitis, especially phlyctenular keratitis) have never been substantiated by direct observation but only suspected by indirect histopathological circumstantial evidence. This has long lost credibility and should never have been taken for real evidence. However, degenerative types of Salzmann's nodular degeneration besides the dystrophic type still exist but the etiology and pathogenesis of these degenerative types have not yet been sufficiently described. No distinction has been made in studies of Salzmann's nodular degeneration up to now between dystrophic and degenerative types which could render such publications worthless on re-evaluation. While therapy of Salzmann's dystrophy is usually simple even after recurrence this may be different with the degenerative forms. The many questions and inconsistencies which have long been noted with "Salzmann's degeneration" as it has been misunderstood, can only be answered and solved if dystrophy and degeneration are investigated separately in future studies.

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Correlation Between Clinical In Vivo Confocal Microscopic and Ex Vivo Histopathologic Findings of Salzmann Nodular Degeneration

Abstract: In vivo confocal microscopy confirmed the clinicopathologic findings of Salzmann's nodular degeneration. Observations by in vivo confocal microscopy were consistent with the histopathologic descriptions of SND.

Cited by 25 publications

References 14 publications

Superficial keratectomy, PTK, and mitomycin C as a combined treatment option for Salzmann's nodular degeneration: a follow-up of eight eyes

Superficial keratectomy, PTK, and mitomycin C as a combined treatment option for Salzmann's nodular degeneration: a follow-up of eight eyes

Bilateral Salzmann-like nodular corneal degeneration after laser in situ keratomileusis imaged with anterior segment optical coherence tomography and high-frequency ultrasound biomicroscopy

Salzmannsche noduläre Hornhautdegeneration

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