PMC6324130_01
Corneal anterior segment photography and optical coherence tomography images of the patient. (a and b) Cystine crystals were observed in the stroma. Cystine crystals were seen as hyperreflective dots in the stroma at optical coherence tomography. The depth of crystals and central corneal thickness was measured with anterior segment photography and optical coherence tomography. (c) Right eye before treatment, central corneal thickness: 559 mum, depth of crystals: 345 mum. (d) Left eye before treatment, central corneal thickness: 556 mum, depth of crystals: 334 mum. (e) Right eye with 1 year after treatment, central corneal thickness: 558 mum, depth of crystals: 336 mum. (f) Left eye with 1 year after treatment, central corneal thickness: 553 mum, depth of crystals: 331 mum
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F1
Corneal crystal deposits were observed in both eyes at the slit-lamp examination [Fig. 1]. AS-OCT showed cystine crystals as hyperreflective dots in the anterior and mid-stroma with the depth of 415 mum (CCT: 559 mum) in the right eye and 428 mum (CCT: 556 mum) in the left eye [Fig. 1]. AS-OCT images showed no change with the depth of crystals in the stroma 1 year after treatment [Fig. 1].
Corneal in vivo confocal microscopy images of the patient. (a-e) Demonstrate the right eye and (k-o) demonstrate the left eye before treatment. (f-j) Demonstrate the right eye and (p-t) demonstrate the left eye after treatment. Cystine crystals started to accumulate in subbasal nerve layer (b, g, l and q) and the most intense deposition was in anterior stroma (c, d, m and r). No crystal was observed in endothelium (e, j, o and t). The depth of accumulation was not significantly changed but the density and size of the crystals were decreased
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F2
IVCM demonstrated that there were no cystine crystals in the epithelium and endothelium [Fig. 2]. Density and size of cystine crystals were decreased in both eyes 1 year after treatment but there was no significant change with the depth of crystals in the IVCM of the cornea [Fig. 2].