Eleiwa Taher, Raheem Mariam, Patel Nimesh A, Berrocal Audina M, Grajewski Alana, Abou Shousha Mohamed
Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA.
Department of Ophthalmology, Faculty of Medicine, Benha University, Benha, Egypt.
Case Rep Ophthalmol Med. 2020 Mar 20;2020:4381273. doi: 10.1155/2020/4381273. eCollection 2020.
This case series demonstrate diagnostic features, treatment options, and challenges for Brittle Cornea Syndrome. . Three cases presented with bluish sclera and extremely thin cornea. Genetic workup was performed and confirmed the diagnosis of Brittle Cornea Syndrome, a rare autosomal recessive disorder characterized by corneal thinning and blue sclera. Case 1 was a 4-year-old boy who developed cataract and glaucoma after undergoing right tectonic penetrating keratoplasty (PK) secondary to a spontaneous corneal rupture. Glaucoma was controlled medically. Later, the kid underwent right transcorneal lensectomy and vitrectomy with synechiolysis. After 6 weeks, he sustained graft dehiscence that was repaired using onlay patch graft. Case 2 was a 7-year-old boy who underwent PK in the right eye, then a pericardial patch graft in the left eye following spontaneous corneal rupture. Glaucoma in both eyes was controlled medically. Case 3 was the 2-year-old sister of the 2 case. She had a pachymetry of 238 m OD and 254 m OD and 254 .
Long-term follow-up of children diagnosed with Brittle Cornea Syndrome is paramount to minimize the morbidity of corneal rupture and late-onset extraocular conditions.
本病例系列展示了脆性角膜综合征的诊断特征、治疗选择及挑战。三例患者表现为蓝色巩膜和极薄的角膜。进行了基因检查,确诊为脆性角膜综合征,这是一种罕见的常染色体隐性疾病,其特征为角膜变薄和蓝色巩膜。病例1是一名4岁男孩,因自发性角膜破裂继发右眼结构性穿透性角膜移植术(PK)后出现白内障和青光眼。青光眼通过药物控制。后来,该患儿接受了右眼经角膜晶状体切除术和玻璃体切除术及粘连松解术。6周后,他发生植片裂开,使用覆盖补片移植进行修复。病例2是一名7岁男孩,右眼接受了PK,随后左眼在自发性角膜破裂后接受了心包补片移植。双眼青光眼通过药物控制。病例3是病例2的2岁妹妹。她右眼角膜厚度为238μm,左眼为254μm。
对诊断为脆性角膜综合征的儿童进行长期随访对于将角膜破裂和迟发性眼外疾病的发病率降至最低至关重要。