PMC2836525_01
The photograph demonstrates the central keratectasia with an anterior corneal steepening from the side (1a). The thinned central cornea within the 7 mm central optical zone is "bulged" forward with a edematous swelling of approximately 1450 mum similar to an acute keratoconus. Figure 1(b): the photograph of the frontside demonstrated the location of the corresponding OCT-scan.
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fig1
The diagnosis of acute keratoconus-like hydrops was made based on the progressive central edematous steepening of the corneal stroma (Figure 1) and a penetrating keratoplasty was recommended.
Horizontal OCT-scan displays a logarithmic false-colors image of the entire cornea OD composed of 7 images. Each OCT-scan has length of 4.07 mm represented by 100 columns and a depth of 1500 mum represented by 300 pixels. OCT determined the cornea as a hyporeflective band in light greenish colors. While the lateral cornea has a normal thickness and appears steepend, the central cornea in a diameter of approximately 7.5 mm has a flatt curvature with an intrastromal low reflectivity, consistent with a severe intrastromal edema of approximately 1250 mum.
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fig2
Tomographic scans using optical coherent tomography (OCT) confirmed an anterior corneal steepening and acute keratoconus-like excessive edematous swelling of approximately 1250-mum (Figure 2).
Light microscopy revealed a partially detached epithelium. The stromal architecture was rarified and the space between separate corneal lamellae edematous swollen. The descement and endothelial appeared undamaged.
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fig3
On light microscopy the stromal architecture appeared rarified and the space between separate corneal lamellae was edematously swollen (Figure 3).