PMC7273428_01
Corneal findings in the right (a, c, and e) and left (b, d, and f) eyes. (a, b) Slit-lamp examination shows corneal sterile infiltration and neovascularization in the temporal-lower side of the right eye and in the nasal-lower side of the left eye at the initial visit. (c, d) Two weeks after the initial visit (after topical agents were discontinued and replaced with betamethasone), slit-lamp examination showed a marked regression of the corneal vascularization and decreased corneal opacity bilaterally, while the area of the corneal opacity remained unchanged. (e, f) Six weeks after the initial visit, corneal opacity, intermixed with separate transparent sections, was clearly seen bilaterally, while the area of the corneal opacity remained unchanged.
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fig1
OU. Ocular examination revealed follicular conjunctivitis and blepharitis OU and corneal sterile infiltration with neovascularization in the temporal lower side OD and in the nasal lower side OS (Figures 1(a) and 1(b)). Two weeks after the discontinuation of topical drugs and administration of betamethasone, both the blepharitis and corneal sterile infiltration markedly improved (Figures 1(c) and 1(d)). Six weeks after the initial visit, corneal opacity, intermixed with separate transparent sections, was clearly seen bilaterally (Figures 1(e) and 1(f)).
Anterior-segment optical coherence tomography (OCT) images in the right (a, c, and e) and left (b, d, and f) eyes. (a, b) Anterior OCT images showing opacity deep in the marked thickening corneal stroma in both eyes at the initial visit. (c, d) Two weeks after the initial visit (after topical agents were discontinued and replaced with betamethasone), an improvement of the thickened corneal stroma was observed. (e, f) Six weeks after the initial visit, corneal stromal thickness improved almost back to normal.
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fig2
Anterior-segment optical coherence tomography (OCT) showed a marked corneal opacity and thickened corneal stroma OU (Figures 2(a) and 2(b)). OCT showed an improvement in the thickened corneal stroma (Figures 2(c) and 2(d)). Corneal stromal thickness improved almost normally, while the area of the corneal opacity remained unchanged (Figures 2(e) and 2(f)).
In vivo confocal microscopic (IVCM) images (a-f): (a) the basal epithelium (12 mum depth), (b) subbasal nerve plexus (129 mum depth), (c) anterior stroma (206 mum depth), (d) mid stroma (235 mum depth), (e) posterior stroma (266 mum depth), and (F) endothelium (483 mum depth). IVCM showed hyperreflective materials with needle-like structures in the corneal stroma (d arrows). Each image represents a 400 x 400 mum2 area.
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fig3
Tomograph II Rostock Cornea Module) showed hyperreflective materials with needle-like structures in the corneal stroma (Figures 3(a)-3(f)). The progression of corneal thinning and definite lipid deposition was not detected during the 18-month follow-up period.