Myxomatous Corneal Degeneration: A Clinicopathological Study of Six Cases and a Review of the Literature

Belliveau, Michel J.; Liao, Walter; Brownstein, Seymour; Manusow, Joshua S.; Jordan, David R.; Gilberg, Steven; Mintsioulis, George

doi:10.1016/j.survophthal.2011.09.006

Cited by 14 publications

(19 citation statements)

References 26 publications

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“…Frequently associated with myxomatous degeneration (i.e., the pathological weakening of the connective tissue), MVP is the most common cause of mitral regurgitation and affects 2–22% of the general population [31]. It has been shown that myxomatous degeneration affecting the cornea shares some features with KC; the damage is present particularly in the anterior part of the stroma, Bowman's membrane is disrupted, and stromal keratocytes are transformed into cells with myofibroblastic differentiation [32]. Since the alteration of collagen subtypes occurs in both KC and MVP, it is possible that a single event during embryogenesis affects both structures, for both the corneal stroma and the atrioventricular valves form during the sixth to seventh week of fetal life [9, 16].…”

Section: Discussionmentioning

confidence: 99%

Impaired Corneal Biomechanical Properties and the Prevalence of Keratoconus in Mitral Valve Prolapse

Akçay

Uysal

et al. 2014

Journal of Ophthalmology

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Objective. To investigate the biomechanical characteristics of the cornea in patients with mitral valve prolapse (MVP) and the prevalence of keratoconus (KC) in MVP. Materials and Methods. Fifty-two patients with MVP, 39 patients with KC, and 45 control individuals were recruited in this study. All the participants underwent ophthalmologic examination, corneal analysis with the Sirius system (CSO), and the corneal biomechanical evaluation with Reichert ocular response analyzer (ORA). Results. KC was found in six eyes of four patients (5.7%) and suspect KC in eight eyes of five patients (7.7%) in the MVP group. KC was found in one eye of one patient (1.1%) in the control group (P = 0.035). A significant difference occurred in the mean CH and CRF between the MVP and control groups (P = 0.006 and P = 0.009, resp.). All corneal biomechanical and topographical parameters except IOPcc were significantly different between the KC-MVP groups (P < 0.05). Conclusions. KC prevalence is higher than control individuals in MVP patients and the biomechanical properties of the cornea are altered in patients with MVP. These findings should be considered when the MVP patients are evaluated before refractive surgery.

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Section: Discussionmentioning

confidence: 99%

Impaired Corneal Biomechanical Properties and the Prevalence of Keratoconus in Mitral Valve Prolapse

Akçay

Uysal

et al. 2014

Journal of Ophthalmology

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“…To the best of our knowledge, 21 cases have been published so far 3 – 19 . The largest published series documents 6 cases 4 . All the previous reports in the literature indicate the benign nature of this lesion.…”

Section: Introductionmentioning

confidence: 99%

Clinical features and histopathological analysis of corneal myxoma

Alqahtani

Alkatan

Khandekar

et al. 2022

Sci Rep

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To describe the presentation, histopathological characteristics, and management outcomes for corneal myxoma. This one-armed cohort study evaluated histologically confirmed consecutive cases of corneal myxoma. Data were evaluated on demographics, clinical presentation, management, histopathological and immunohistochemical features, and outcomes; visual acuity and corneal clarity. The study sample was comprised of 10 eyes (10 patients). The median age at presentation was 10.5 years. Five eyes had high intraocular pressure, four eyes had decreased distance visual acuity and one eye became discolored. Surgical management included penetrating keratoplasty (8 eyes), phototherapeutic keratectomy (1 eye), and evisceration because of a blind painful eye (1 eye). Postoperative best-corrected distance vision ranged from 20/20 to 20/60 (1 eye), < 20/60 to 20/200 (2 eyes), < 20/200 to 20/400 (1 eye), < 20/200 to light perception (4 eyes) and no light perception (1 eye). The histopathology of these lesions showed typical subepithelial proliferating spindle-shaped cells of mesenchymal origin within a myxoid stroma rich in glycosaminoglycan. The median duration of follow-up was 5 years. Recurrence was observed in an eye that underwent local excision. Corneal myxoma is a rare lesion that is presumably isolated, secondary, and reactive in nature. Surgically management yields reasonably favorable outcomes.

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“…Like the cornea, the human heart valves are rich in collagen tissues, with a majority of types I and V collagen and a small proportion of type III [ 11 , 12 ]. It is worth noting that in myxomatous degeneration, pathological weakening of the connective tissue plays an important role in the pathophysiology of both KCN and MVP [ 8 , 21 ]. In addition, several reports have shown restricted lysyl oxidase distribution and reduced total lysyl oxidase activity in keratoconic corneas [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Risk of Mitral Valve Prolapse in Patients with Keratoconus in Taiwan: A Population-Based Cohort Study

Chang

Tai

Weng

et al. 2020

IJERPH

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This retrospective, nationwide, matched-cohort study included 4488 new-onset keratoconus (KCN) patients, ≥12 years old, recruited between 2004 and 2011 from the Taiwan National Health Insurance Research Database. The control group included 26,928 non-KCN patients selected from the Taiwan Longitudinal Health Insurance Database 2000. Information for each patient was collected and tracked from the index date until December 2013. The incidence rate of mitral valve prolapse (MVP) was 1.77 times (95% confidence interval (CI) = 1.09–2.88; p = 0.0206) higher in KCN patients ≥40 years old and 1.49 times (95% CI = 1.12–1.98; p = 0.0060) higher in female KCN patients than in controls. After using the Cox proportional hazard regression analysis to adjust for potential confounders, including hypertension, hyperlipidemia, and congestive heart failure, KCN maintained an independent risk factor, MVP being 1.77 times (adjusted hazard ratio (HR) = 1.77, 95% CI = 1.09–2.88) and 1.48 times (adjusted HR = 1.48, 95% CI = 1.11–1.97) more likely to develop in patients ≥40 years old and female patients in the study cohort, respectively. We found that KCN patients ≥40 years of age and female KCN patients have increased risks of MVP. Therefore, it is recommended that KCN patients should be alerted to MVP.

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Myxomatous Corneal Degeneration: A Clinicopathological Study of Six Cases and a Review of the Literature

Cited by 14 publications

References 26 publications

Impaired Corneal Biomechanical Properties and the Prevalence of Keratoconus in Mitral Valve Prolapse

Impaired Corneal Biomechanical Properties and the Prevalence of Keratoconus in Mitral Valve Prolapse

Clinical features and histopathological analysis of corneal myxoma

Risk of Mitral Valve Prolapse in Patients with Keratoconus in Taiwan: A Population-Based Cohort Study

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