PMC6311300_01
Anterior segment photography and corresponding AS-OCT image of the preoperative condition. It shows a round 4 x 4 mm corneal ulcer reaching the deep stroma, associated with massive melting surrounding the edema and perikeratic injection.
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fig1
Despite the therapy modification, the corneal situation continued to worsen, with a perikeratic injection and increased size of the round corneal ulcer (4 mm in diameter) involving the optical zone and reaching the deep stroma (Figure 1) with massive melting and surrounding edema.
Anterior segment photography follow-up after CXL-WA: 1 day, 1 week, 1 month, and 2 months showing initial apparent stability of the clinical condition.
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fig2
Anterior segment photography and AS-OCT showing a central 2x2 mm descemetocele with a thinning of the cornea (232 mum centrally and 116 mum peripherally).
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fig3
PAS positive section showing the focal erosion of the epithelium with a full thickness mixed inflammatory infiltrate, including lymphocytes, histiocytes, and granulocytes. Note the presence, in this context, of numerous branching hyphae which are highly suggestive of fungal keratitis.
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fig4
The histological evaluation of the removed corneal tissue revealed the presence of numerous branching hyphae and fungal infection (Figure 4).