J Korean Ophthalmol Soc.  2013 Nov;54(11):1783-1787. 10.3341/jkos.2013.54.11.1783.

Confocal Microscopic Findings in Posterior Polymorphous Corneal Dystrophy

• Choi BS
• Park YM
• Lee JS

• KMID: 2217928
• DOI: http://doi.org/10.3341/jkos.2013.54.11.1783

Abstract

PURPOSE
To analyze the features of corneal tissue in patients with posterior polymorphous corneal dystrophy (PPMD) using in vivo confocal microscopy (IVCM).
CASE SUMMARY
Three patients with clinically diagnosed PPMD were examined using IVCM. Cross-sectioned corneal images of the corneal epithelium, Bowman's layer, stromal layer, Descemet's membrane, and endothelium were evaluated. IVCM demonstrated a depressed crater-like lesion, hyper-dense streak-like lesion, and surface irregularity of the corneal endothelium. Endothelial hypo-reflective vesicular and band-like lesions were also found. Pleomorphism and polymegathism were present with guttae and hyper-reflective endothelial nuclei.
CONCLUSIONS
IVCM is a non-invasive and effective tool to diagnose PPMD.

Keyword

Confocal microscopy; Posterior polymorphous corneal dystrophy

MeSH Terms

Corneal Dystrophies, Hereditary
Descemet Membrane
Endothelium
Endothelium, Corneal
Epithelium, Corneal
Humans
Microscopy, Confocal

Figure

• 

  Figure 1. Slit-lamp photographs of the posterior polymorphous corneal dystrophy patient (case 1). Rail-road like bands on the endothelial surface (black arrows). Below the band like lesion, multiple small vesicles (black arrow- heads) are observed.

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  Figure 2. In vivo confocal microscopic findings of the posterior polymorphous corneal dystrophy patient (case 1). (A) Hyper-reflective endothelial nuclei (black arrows). (B) Undulating endothelial surface, depressed crater-like lesion and vesicles are noted at the endothelial level (black arrows).

• 

  Figure 3. In vivo confocal microscopic findings of the posterior polymorphous corneal dystrophy patient (case 2). (A) Endothelial vesicular lesions in curvilinear pattern with associated endothelial pleomorphism and polymegatism. (B) Focal vesicular endothelial lesions (black arrows). (C) Undulating endothelial surface with depressed crater-like lesion and hyper dense streak-like lesion (black arrows). Vesicles and guttata (black arrowheads) are also noted.

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  Figure 4. In vivo confocal microscopic findings of the posterior polymorphous corneal dystrophy patient (case 3). Endothelial vesicular lesions in curvilinear pattern with associated endothelial pleomorphism and polymegatism. Undulating endothelial surface with depressed crater like lesion is also noted.

Reference

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