Ghanem Ramon C, Ghanem Vinícius C, Victor Gustavo, Alves Milton Ruiz
Department of Cornea and Refractive Surgery, Sadalla Amin Ghanem Eye Hospital, Joinville, SC 89201, Brazil.
Case Rep Ophthalmol Med. 2012;2012:731413. doi: 10.1155/2012/731413. Epub 2012 May 10.
Purpose. To report two unusual cases of idiopathic lipid keratopathy with symmetrical bilateral annular corneal lipid infiltration and describe confocal microscopy findings. Methods. Case reports. Results. We report two patients with bilateral peripheral deep stromal lipid deposits beginning in an arcuate pattern and progressing to a complete annular shape. Cholesterol crystals were observed in the paracentral area in both cases with characteristic crystalline-like structures in the confocal microscopy. Deep thin corneal blood vessels were observed in one patient, but no cause for then was established, despite decades of followup. This patient had an idiopathic limbitis as well, occurring in episodes. No previous ocular trauma, systemic disease or family history was reported for both cases. Conclusion. These two cases of idiopathic annular lipid keratopathy were observed for more than a decade with documented slow and insidious progression of the infiltrates, in spite of the use of topical steroids in one case. In the majority of other reported cases, a penetrating keratoplasty was made necessary. Differently, we showed that the visual acuity can remain quite good for years with very slow deterioration.
目的。报告两例罕见的特发性脂质角膜病变，伴有双侧对称性环形角膜脂质浸润，并描述共聚焦显微镜检查结果。方法。病例报告。结果。我们报告了两名患者，其双侧周边深层基质脂质沉积始于弓形并进展为完整的环形。两例患者的旁中央区域均观察到胆固醇结晶，共聚焦显微镜检查显示出特征性的晶体样结构。在一名患者中观察到深层薄角膜血管，但尽管进行了数十年的随访，仍未确定其病因。该患者还患有发作性特发性睑缘炎。两例患者均未报告有先前的眼外伤、全身性疾病或家族病史。结论。这两例特发性环形脂质角膜病变患者被观察了十多年，尽管其中一例使用了局部类固醇，但浸润仍有记录显示进展缓慢且隐匿。在其他大多数报告的病例中，需要进行穿透性角膜移植术。不同的是，我们表明视力可以多年保持相当良好，且恶化非常缓慢。
