PMC6046143_01
Superotemporal limbal ulcer of Patient 1. Panel (a): slit-lamp examination (white arrow indicates primary area of thinning). Panel (b): AS-OCT image at presentation demonstrating area of significant ulceration and thinning measured at 380 microns. The interface of the abnormal and normal cornea appears to be the most hyperreflective, which may be a sign of higher density of cellular materials in this region. Panel (c): AS-OCT six months after presentation with flattening of the ulcer and subsequent improvement of thinning to 537 microns after medical therapy. The cystic region that remains to the right of the arrow may be an area of abnormal healing.
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fig1
After this was discontinued and prednisone was used for three months, she improved and has been stable with a BCVA of 20/25.  Figure 1 demonstrates a slit-lamp photograph of the case at presentation and AS-OCT images before and after treatment.
PMC6046143_02
Inferotemporal limbal ulcer of Patient 2. Panel (a): slit-lamp examination with white arrow drawn across primary area of thinning. Panel (b): anterior segment optical coherence tomography (AS-OCT) image at presentation demonstrating area of significant corneal thinning (measured at 330 microns) and irregularity adjacent to an area of relatively normal cornea. As in Figure 1, the ulcer edges and interface between abnormal and normal cornea demonstrate hyperreflectivity. Panel (c): AS-OCT six months after presentation with improvement of thinning to 450 microns after medical therapy.
CRIOPM2018-3705753.002.jpg
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fig2
At his last visit, 16 months after presentation, he remains asymptomatic with a BCVA of 20/30.  Figure 2 demonstrates a slit-lamp photograph taken at presentation and AS-OCT images taken before and after treatment.