F.I. Proctor Foundation, San Francisco, CA, USA.
Cornea. 2012 Dec;31(12):1446-8. doi: 10.1097/ICO.0b013e31823f777f.
Thygeson superficial punctate keratitis (TSPK), a chronic, inflammatory disease, has traditionally been taught to resolve spontaneously and without scarring. We present 4 cases with TSPK who developed sight-altering scarring after a prolonged disease course.
Retrospective chart review of cases seen at the Proctor Medical Group.
Patients age ranged from 31 to 68 years. All patients were male and had been symptomatic from 2 to 53 years. Follow-up period ranged from 1 month to 35 years. All 3 patients developed significant corneal scarring. Case 1 had bilateral corneal thickening and a Salzmann nodule with vascularization. Case 2 had bilateral stromal opacification. Case 3 developed corneal scarring to the point of needing an anterior lamellar corneal transplant. Pathological evaluation of this tissue showed disruption of the Bowman layer with band keratopathy, thickening of the basement membrane, and subepithelial fibrosis. The diagnosis of TSPK in these cases was never in doubt, 2 of the cases having been diagnosed by Dr Thygeson.
Prolonged corneal inflammation associated with TSPK can cause visually significant scarring of the anterior corneal stroma. In those patients with chronic disease, the use of a topical corticosteroid may be needed not just for comfort but to reduce the risk of corneal scarring.
特发性点状表层性角膜炎（TSPK）是一种慢性炎症性疾病，传统上认为其会自行消退且不会留下疤痕。我们报告了 4 例 TSPK 患者，他们在疾病长期发展后出现了影响视力的疤痕。
回顾性分析在 Proctor 医疗集团就诊的病例。
患者年龄 31-68 岁，均为男性，症状持续 2-53 年。随访时间 1 个月至 35 年。3 例患者均出现明显的角膜疤痕。病例 1 双侧角膜增厚，伴 Salzmann 结节和血管化；病例 2 双侧基质混浊；病例 3 发展为角膜疤痕，需要进行前板层角膜移植。对该组织进行病理评估显示，Bowman 层中断伴带状角膜病变，基底膜增厚和上皮下纤维化。这些病例的 TSPK 诊断从未有过疑问，其中 2 例由 Thygeson 博士诊断。
与 TSPK 相关的长期角膜炎症可导致前部角膜基质的显著疤痕形成。对于慢性疾病患者，使用局部皮质类固醇不仅可以缓解不适，还有助于降低角膜疤痕形成的风险。
