PMC8422938_01
A) CIN with 360-degree limbal involvement; B) Perilimbal gelatinous lesion with vascular loops; C) CIN with perilimbal lesion extending to the temporal bulbar conjunctiva
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F1
There was 360 degrees of gelatinous limbal thickening with vascular loops suspicious for CIN (Figure 1A, B (Fig. 1)). Also noted was significant extension of the lesion temporally onto the lateral bulbar conjunctiva (Figure 1C (Fig. 1)).
Enlarging epithelial defect and hypopyon
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F2
Slit lamp examination showed a new hypopyon, engorged iris vessels, and posterior synechiae consistent with acute non-granulomatous anterior uveitis (Figure 2 (Fig. 2)).
Enlargement of CIN, increased corneal epithelial defect size
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F3
The patient was seen in follow-up three weeks later, and significant growth of the CIN was noted (Figure 3 (Fig. 3)).
Diminished CIN two weeks after starting 5-FU; note regressing superior vessels
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F4
The epithelial defect remained stable at 5.5x6 mm (Figure 4 (Fig. 4)).
Diminished CIN, resolving epithelial defect 1.5 months after 5-FU therapy initiation
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F5
Ambiodisk amniotic membrane and Kontur lens were placed in the left eye for the persistent epithelial defect. After six weeks of topical 5-FU, the patient was noted to have near resolution of the CIN (Figure 5 (Fig. 5)).
Resolution of CIN, small inferior corneal neovascularization, resolved epithelial defect with scarring and some residual amniotic membrane inferotemporally
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F6
Finally, six months after initial presentation, the persistent corneal epithelial defect was resolved after suture tarsorrhaphy, multiple amniotic membranes, and bandage contact lenses (Figure 6 (Fig. 6)).