PMC3617894_01
Subepithelial opacity (arrows) in the mid-peripheral to peripheral cornea and numerous opacities located near Descemet's membrane (arrow heads) from a 41-year-old male; similar findings were observed in both eyes. a Photograph with narrow slit illumination. b Photograph with wide slit illumination.
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F1
Slit-lamp biomicroscopy revealed a subepithelial opacity in the mid-peripheral to peripheral cornea OU and numerous opacities located at the level of Descemet's membrane OU; however, it was difficult to distinguish precisely the location of the opacity (i.e. deep stroma or Descemet's membrane) (fig. 1).
In vivo laser confocal microscopic image by Heidelberg Retina Tomograph 2 Rostock Cornea Module (Heidelberg Engineering GmbH, Dossenheim, Germany). Similar findings were observed in both eyes. No differences were detected between the central and peripheral regions (scale bar = 50 mum). a The superficial epithelial cell layer was normal. b The basal epithelial cell layer was normal. c In the subepithelium to Bowman's layer, numerous hyperreflective particles were observed. d In the superficial stroma, numerous hyperreflective particles were observed. e The midstroma was normal. f, g The deep stroma was normal. Hyperreflective inclusions as in pre-Descemet's membrane corneal dystrophy were not observed. h Descemet's membrane itself had high reflectivity. i The endothelial cell layer was normal.
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F2
In vivo laser confocal microscopy (Heidelberg Retina Tomograph 2 Rostock Cornea Module, Heidelberg Engineering GmbH, Dossenheim, Germany) showed numerous hyperreflective particles in the subepithelium to superficial stroma OU (fig. 2c, d) and hyperreflectivity of Descemet's membrane OU (fig. 2h). No abnormal findings were noted in the epithelial cell layer, midstroma, deep stroma, and endothelial cell layer (fig. 2a, b, e-g, i).
a The unused soft contact lens (Aime super-soft, Aime, Yokohama, Japan) had a light blue color. The hydroxyethyl methacrylate-based contact lens was categorized as FDA group I (low water content, nonionic). b One-year used soft contact lens showed a brownish discoloration. Similar discoloration was noted in both of the patient's contact lenses. Metal deposition was not detected with differential interference contrast microscope.
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F3
Although his used soft contact lens OU showed a brown discoloration, metal deposition was not detected with differential interference contrast microscope (fig. 3b).