Atypical presentation of Salzmann nodular degeneration diagnosed with ultra-high-resolution optical coherence tomography.

A 59-year-old woman presented with bilateral, peripheral, circular corneal infiltrates. There was a clear zone separating the outer margin of the degeneration from the limbus in both eyes. The inner margins were indistinct. Ultra-high-resolution optical coherence tomography (UHR-OCT) imaging demonstrated subepithelial infiltrations with epithelial thinning and corneal surface elevation. The infiltrate was accompanied by significant stromal scarring, which reached deep layers of the corneal stroma. UHR-OCT findings were consistent with Salzmann nodular degeneration. UHR-OCT can be used as an optical biopsy to diagnose atypical corneal degenerations without tissue sampling.