上方角膜透明边缘变性

Superior pellucid marginal corneal degeneration.

作者信息

Sridhar M S, Mahesh S, Bansal A K, Rao G N

机构信息

Cornea Center, LV Prasad Eye Institute, Hyderabad, India.

出版信息

Eye (Lond). 2004 Apr;18(4):393-9. doi: 10.1038/sj.eye.6700643.

DOI:10.1038/sj.eye.6700643

PMID:15069437

Abstract

PURPOSE

To report the clinical features and topographic findings of superior pellucid marginal corneal degeneration (PMCD).

METHODS

Retrospective chart review of 15 eyes of eight patients of superior PMCD. Detailed history, visual acuity at presentation, degree of astigmatism, slit-lamp examination findings, topographic features, and Orbscan findings were noted where available. Improvement in visual acuity with spectacles or contact lens correction, surgical procedure if any, and final visual acuity were analysed.

RESULTS

In all, six patients were males and two were females. All cases except one were bilateral. The patients ranged in age from 18 to 48 years. All cases had isolated superior PMCD. One patient was a diagnosed case of vernal keratoconjunctivitis. The visual acuity at presentation ranged from hand motions to 20/25. The degree of thinning varied from 30 to 90%. The extent of thinning was commonly seen between the 10 and 2 o'clock positions. Ectasia was seen below the site of thinning in all the cases of superior PMCD. Topographic features including vertical corridor of reduced power, against-the-rule astigmatism and superior loop cylinder were seen in 10 eyes. Orbscan was carried out in two eyes of one patient and revealed an area of increased elevation in relation to the best-fit sphere superiorly corresponding to the area of ectasia in both the eyes. The visual acuity improved with rigid gas-permeable contact lens in six eyes and the final visual acuity ranged from 20/400 to 20/30. Two eyes were subjected to surgical intervention (peripheral annular graft=1 and lamellar graft=1).

CONCLUSIONS

PMCD can occur superiorly. It should be considered in the differential diagnosis of superior ectatic disorders. The topographic findings, of reduced power in the vertical meridian and superior loop cylinder, are typical of superior pellucid marginal degeneration. Visual rehabilitation is usually possible with contact lenses, with surgical management required in selected cases.

摘要

目的

报告上方透明边缘角膜变性（PMCD）的临床特征和地形图表现。

方法

对8例上方PMCD患者的15只眼进行回顾性病历分析。记录详细病史、就诊时视力、散光度数、裂隙灯检查结果、地形图特征以及Orbscan检查结果（若有）。分析佩戴眼镜或隐形眼镜矫正后视力的改善情况、是否进行手术及最终视力。

结果

总共6例男性，2例女性。除1例为单眼外，其余均为双眼患病。患者年龄在18至48岁之间。所有病例均为单纯上方PMCD。1例患者被诊断为春季角结膜炎。就诊时视力从手动视力到20/25不等。变薄程度从30%至90%不等。变薄范围常见于10点至2点位置之间。所有上方PMCD病例在变薄部位下方均可见角膜膨隆。10只眼中观察到包括垂直低屈光力通道、逆规散光和上方环形柱镜等地形图特征。对1例患者的2只眼进行了Orbscan检查，结果显示相对于最佳拟合球面，上方有一个抬高区域，与双眼角膜膨隆区域相对应。6只眼佩戴硬性透气性隐形眼镜后视力得到改善，最终视力范围从20/400至20/30。2只眼接受了手术干预（周边环形移植1例，板层移植1例）。