Pang Yilin, Zhang Qin, Bao Yongzhen
Department of Ophthalmology, Peking University People's Hospital.
Eye Diseases and Optometry Institute.
Medicine (Baltimore). 2019 Aug;98(35):e16589. doi: 10.1097/MD.0000000000016589.
Lipid deposition on the cornea without previous infection, inflammation, vascularization, or trauma is idiopathic lipid keratopathy. In vivo laser confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS-OCT) are 2 noninvasive methods that can help identify the structures and morphological characteristics of the focus.
A 63-year-old woman with ipsilateral corneal lipid deposits developing from a small white spot into a yellow-white superotemporal elliptic shape within a year. AS-OCT showed peripheral deep stromal deposits. IVCM showed hyper-reflective material with typical crystalline-like or needle-like structures in the superotemporal area.
Idiopathic lipid degeneration.
Topical steroids eye drops 3 times a day for a month and further consultation every 3 months.
This patient of idiopathic lipid keratopathy was observed every 3 months and till now we have reviewed this patient twice. Topical steroids eye drops were only used during the first month. No further development was observed about the lesion and the patient's visual acuity remained good.
IVCM and AS-OCT can help identify the characteristic crystalline-like or needle-like hyper-reflective material that could help diagnosis of idiopathic lipid degeneration.
在无前驱感染、炎症、血管化或创伤情况下角膜上的脂质沉积为特发性脂质角膜病变。活体激光共聚焦显微镜检查(IVCM)和眼前节光学相干断层扫描(AS-OCT)是两种可帮助识别病灶结构和形态特征的非侵入性方法。
一名63岁女性,同侧角膜脂质沉积在一年内从小白点发展为黄白色颞上椭圆形。AS-OCT显示周边深层基质沉积。IVCM显示颞上区域有具有典型晶体样或针状结构的高反射物质。
特发性脂质变性。
局部用类固醇眼药水,每天3次,持续1个月,每3个月进一步会诊。
对该特发性脂质角膜病变患者每3个月观察一次,至今已复查两次。仅在第一个月使用局部类固醇眼药水。病变未进一步发展,患者视力保持良好。
IVCM和AS-OCT有助于识别可帮助诊断特发性脂质变性的特征性晶体样或针状高反射物质。