Is hyaline degeneration of the cornea a precursor of Salzmann's corneal degeneration?

Abstract

Table 1 Clinical characteristics Age Sex VA Visual fields Visual hallucinations 79 F RE 20/20 Humphrey 24-2; constriction to 15 degrees; MD −16.68 dB "like dreaming while awake. . .water dripping from the ceiling" LE 20/25 Humphrey 24-2; complete loss of inferior nasal field; MD −12.61 dB 82 F RE 20/80 Humphrey 81-3 zone; 51/81 points not seen "A changing visual panorama. . .halls green with diamond-like pattern. . .blue flowers covering the bathroom. . .small red and grey tiles on the carpet. . .the walls looked like they were made of brick" LE FC Confrontation; FC ability in all but inferior nasal field 78 M RE 20/25 Humphrey 81-3 zone; 55/81 points not seen "I saw images of my bedroom wallpaper all over my house. . ." LE 5/200 Humphrey 81-3 zone; 50/81 points not seen 89 F RE 20/40 Humphrey 24-2; MD −3.14 People in the room that were not there. . .people or shadows standing near the elevator LE 20/40 Humphrey 24-2; MD −11.66 Dense inferior field defect VA = visual acuity; MD = mean deviation; FC = finger counting.

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

“…Whereas some authors propose external irritation because of poor corneal protection, hyaline degeneration and an active immune process [14,15] as possible mechanisms of SND, other authors as Vannas [2] conclude that the various causes of earlier inflammation in their case series did not support the idea that immunologic factors play a major role in the etiology of SND, but also hormonal changes affecting the ocular surface seem to play a role in etiology. Graue-Hernandez et al [16] that predominantly white women were affected in the sixth decade of life within their 180 retrospective SND cases.…”

Salzmann Nodular Degeneration

“…Salzmann degeneration is classically described as nodular bluish gray corneal opacities varying in number and size and associated with a variety of visual symptoms and clinical signs of varying degrees. 6,11 Although the exact cause has not been clearly determined, the disease has been associated with previous inflammation of the ocular surface including various forms of keratitis, dry eye, pterygium, and long-term contact lens wear. Recently, Stone et al 12 demonstrated increased expression of matrix metalloproteinase-2 (MMP-2), subepithelial fibrosis populated with fibroblast-like cells, and a disrupted Bowman membrane, proposing that the nodules may arise as a consequence of chronic epithelial remodeling and wound repair mechanisms.…”

“…5 The histopathological findings demonstrate areas of subepithelial fibrosis, disruption of Bowman layer, and thinning of the overlying epithelium. 6 Patients may be asymptomatic or may present with decreased visual acuity, glare, foreign body sensation because of recurrent apical erosions, photophobia, or tearing. Symptoms may vary from very mild to severe, altering quality of life and disturbing visual function.…”

Salzmann Nodular Degeneration After Laser In Situ Keratomileusis

“…5,6 External irritation, because of poor corneal protection, hyaline degeneration, and an active immune process have been proposed as mechanisms. [6][7][8] In our patient, the nodules were located at the interpalpebral region, suggesting exposure keratopathy as a cause, but there was no lagophthalmos or staining defects. A change in the corneal curvature after LASIK may also have altered the normal corneal eyelid and tear film interface and contributed to the pathogenesis of these nodules in our patient.…”