Sridhar M S, Honavar S G, Vemuganti G, Rao G N
Cornea Service, LV Prasad Eye Institute, Hyderabad, India.
Am J Ophthalmol. 2000 Jan;129(1):92-4. doi: 10.1016/s0002-9394(99)00286-x.
To report a case of conjunctival intraepithelial neoplasia presenting as corneal ulcer.
Case report of a 28-year-old man who presented with sudden onset of pain, redness, and watering in the right eye. Examination of right cornea revealed deep stromal infiltrate inferonasally. Adjacent to the infiltrate and straddling the inferonasal limbus, a reddish well-defined sessible lesion with prominent blood vessels was seen. After corneal scraping for microbiological evaluation, the patient was treated with frequent instillation of ciprofloxacin hydrochloride 0.3% eyedrops.
Corneal scraping revealed no microorganisms. Infiltrate resolved promptly after excision of the lesion. Histopathologic evaluation of the excised lesion revealed conjunctival intraepithelial neoplasia.
This case highlights the fact that conjunctival intraepithelial neoplasia at the limbus may present as corneal ulcer. This ulcer could have occurred secondary to a dellen formation and epithelial breakdown predisposing to a corneal ulcer.
报告一例表现为角膜溃疡的结膜上皮内瘤变病例。
对一名28岁男性患者的病例报告,该患者右眼突然出现疼痛、发红和流泪症状。右眼角膜检查发现鼻下象限有深层基质浸润。在浸润灶附近并跨越鼻下象限角膜缘,可见一个边界清晰、呈红色、有明显血管的可触及病变。在进行角膜刮片以进行微生物学评估后,患者接受了频繁滴注0.3%盐酸环丙沙星滴眼液的治疗。
角膜刮片未发现微生物。病变切除后浸润灶迅速消退。对切除病变的组织病理学评估显示为结膜上皮内瘤变。
该病例凸显了角膜缘结膜上皮内瘤变可能表现为角膜溃疡这一事实。这种溃疡可能是由于角膜小凹形成和上皮破损继发,进而易引发角膜溃疡。