Pterygoide Hornhautdystrophie

Wolter-Roessler, Eva; Seitz, Berthold; Naumann, Gottfried O.H.

doi:10.1055/s-2002-35166

Cited by 6 publications

(3 citation statements)

References 11 publications

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“…11,12 The histopathologic findings in our patients were similar to those of pterygoid corneal dystrophy with a discontinuous basement membrane, absence/ fragmentation of Bowman's layer, subepithelial fibrovascular tisse, elastoid degeneration of collagen and elastic fibers, subepithelial hyalinisation of connective tissue, and epithelial cells expressing both cornea-(K12) and conjunctiva-specific markers (K13). 7 This clinically also presents as a bilateral corneal opacification with nasal/temporal involvement and multiple relapses after pterygium surgery at young age and reduced visual acuity because of high irregular astigmatism. This was thought to be associated with an autosomal dominant history of family involvement.…”

Section: Discussionmentioning

confidence: 99%

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Peripheral hypertrophic subepithelial corneal degeneration presenting with bilateral nasal and temporal corneal changes

Schargus

Kusserow

Schlötzer‐Schrehardt

et al. 2014

Eye

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Purpose To characterise the history, clinical and histopathological features of patients with bilateral nasal and temporal peripheral hypertrophic subepithelial corneal degeneration in a German population. Methods A detailed ophthalmological and dermatological history and clinical findings were recorded of nine patients with bilateral simultaneous nasal and temporal peripheral corneal degeneration from two centers in Germany. Excised tissues were studied by histopathology, immunohistochemistry, and transmission electron microscopy. Results Foreign body sensation and need of artificial tear substitutes were the only symptoms reported regularly. Schirmer's and Jones-test were normal in all, but fluorescein break-up time of 410 s was found in five eyes of four patients. Best corrected visual acuity was reduced only under glare conditions. Corneal topography revealed irregular astigmatism in 13 of 14 eyes. Follow-up median time was 35 months. Most cases were stable within the follow-up period. Light and electron microscopy revealed the findings of superficial vascularised corneal hypertrophic scars, oxytatlan fibers, and discontinued Bowmans layer. Conclusion In this series of German patients with peripheral hypertrophic subepithelial corneal degeneration, the changes were predominantly located in the palpebral aperture and often present in both eyes. No associated surface disease could be established in this study. Light and transmission electron microscopy showed histological features that are similar to Salzmann's corneal changes without any inflammation. We hypothesise that light exposure and a localised limbal insufficiency could be involved in the pathogenesis.

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Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7] What has been termed Salzmann's degeneration is predominantly unilateral, presenting at any time in life with a female preponderance. Although the pathophysiology remains undefined until present, chronic ocular surface irritation or inflammation are thought to be the initiating conditions.…”

Section: Introductionmentioning

confidence: 99%

Peripheral hypertrophic subepithelial corneal degeneration presenting with bilateral nasal and temporal corneal changes

Schargus

Kusserow

Schlötzer‐Schrehardt

et al. 2014

Eye

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“…27 Typically, a wide avascular pannus is seen at the head of the pterygium, resembling a flat oval-shaped Salzmann's nodule.…”

Section: Pterygoid Corneal Dystrophymentioning

confidence: 99%

Salzmann's Nodular Degeneration of the Cornea

Das

Link²,

Seitz³

2005

Cornea

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Salzmann's nodular degeneration is a rare, noninflammatory, slowly progressive, degenerative condition. Bluish-white nodules raised above the surface of the cornea characterize it. It has usually developed in corneas with a history of phlyctenulosis, trachoma, vernal keratoconjunctivitis, measles, scarlet fever, and various other viral diseases. However, today the majority of cases have been seen without recognized previous keratitis. It is composed of dense irregularly arranged collagen tissue with hyalinization between epithelium and Bowman's layer or beyond. Manual removal, phototherapeutic keratectomy (PTK) with or without the use of topical mitomycin-C, lamellar or penetrating keratoplasty have been used in the treatment of this disease. Salzmann's nodular degeneration does not seem to consist of one clinical entity. In some cases, elevated and pannus-like tissue can be separated easily from the corneal surface leaving Bowman's layer almost untouched. In these eyes, subsequent PTK may be necessary to smooth the surface. Recurrences are rare in these eyes. In contrast, some eyes (often with major peripheral vascularization) are left with deep defects in Bowman's layer and superficial stroma after difficult mechanical removal of nodules. In these eyes, multiple masking/laser ablation procedures are mandatory to acquire a homogenous surface. In our experience, the required laser ablation depth is significantly greater and the best-corrected visual acuity to be expected is reduced in contrast to the eyes with easy removal of the nodules. In these eyes recurrences seem to occur more frequently after treatment. Of 35 eyes documented to have Salzmann's nodular degeneration during the last 15 years in our department, 22 needed PTK treatment. Visual acuity increased from 0.4 to 0.7 on average. As a routine, laser ablation should be combined with previous conventional removal of nodules and excessive pannus tissue. By doing so, lamellar and penetrating keratoplasty techniques are hardly ever required in those eyes.

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