Fibrillary lines of the cornea. A clinical sign in keratoconus.

Abstract

In the course of studying keratoconus patients, fibrillar structures lying immediately inside Fleischer's ring have been observed. Their arrangement is thought to be characteristic of this condition. They lie at the level of the subepithelium and are identical in form but not in arrangement to similar structures in the normal cornea. These are described in the preceding paper (Bron, 1975). The present paper describes the distribution of fibrillary lines in keratoconus and how they differ from those in normal eyes. Material and methods

Fibrillary lines in overnight orthokeratology

“…A relationship between abrupt change in corneal curvature and the location of fibrillary lines in keratoconus has been reported. Bron and associates 2 observed an annular pattern of fibrillary lines in keratoconic eyes immediately internal to Fleischer’s ring. This ring is believed to occur at the base of the cone at the site of distinct change in corneal curvature.…”

“…The origin of fibrillary lines is unknown. Bron 1 and Bron and co‐workers 2 have suggested that they are neural in origin and represent reorganisation of the sub‐basal and epithelial nerve plexus resulting from changes in normal centripetal epithelial migration patterns. Cheung and colleagues 4 hypothesise that the appearance of fibrillary lines in OK lens wearers may be indicative of epithelial reorganisation induced by OK treatment.…”

“…Fibrillary lines typically appear as vertical, slightly oblique or gently curved greyish‐white fibrils in the epithelium and sub‐epithelial layer. They are a common finding in normal and keratoconic eyes 1–3 . They were first reported in overnight orthokeratology (OK) lens wear by Cheung and colleagues 4 in a young, Asian, highly myopic female patient following 12 months of OK treatment.…”

“…They are a common finding in normal and keratoconic eyes. [1][2][3] They were first reported in overnight orthokeratology (OK) lens wear by Cheung and colleagues 4 in a young, Asian, highly myopic female patient following 12 months of OK treatment. This case report describes a similar finding in an older OK patient with only moderate myopia.…”

Case report: the occurrence of fibrillary lines in overnight orthokeratology

“…In keratoconus, the arrangement of these fibrillary lines is disturbed in several ways; for instance, by taking a path concentric with and internal to the base of the cone, and hence to the location of the Fleischer ring. This is considered to be a response to an altered epithelial migration pattern induced by cone formation (Bron et al. , 1975).…”