Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, Karnataka, India.
Cataract and Refractive Surgery Services, Aro Health, Gurugram, Haryana, India.
Indian J Ophthalmol. 2020 Dec;68(12):3053-3057. doi: 10.4103/ijo.IJO_2554_20.
A 25-year-old male patient presented with chief complaints of itching in both eyes (OU) for the past one month. Detailed ophthalmic examination showed best-corrected visual acuity of 6/6 OU. On slit-lamp examination of the left eye, Vogt's striae were documented and rest of the anterior segment was normal OU. Pentacam-HR and ASOCT confirmed the diagnosis of keratoconus. The patient was started on Trehalose containing preparation for both eyes. On follow-up visit at 8 months, progression was documented on Pentacam-HR. MS-39 showed epithelial remodeling, but no stromal or posterior elevation, indicative of a pseudo-progression. Corneal epithelial remodeling post topical trehalose containing eye drops application has been very sparsely reported in literature. It is an important differential to consider when faced with a situation of a likely progression of keratoconus, especially to differentiate true from pseudo-progression.
一位 25 岁男性患者因双眼瘙痒（OU）持续一个月为主诉就诊。详细的眼科检查显示双眼矫正视力为 6/6。左眼裂隙灯检查发现 Vogt 条纹，其余眼前段正常 OU。Pentacam-HR 和 ASOCT 确诊为圆锥角膜。患者开始在双眼使用含有海藻糖的制剂。8 个月后的随访中，Pentacam-HR 记录到进展。MS-39 显示上皮重塑，但无基质或后表面抬高，提示假性进展。在文献中，角膜上皮重塑在使用含海藻糖的眼药水后非常少见。在面临圆锥角膜进展的可能性时，这是一个需要考虑的重要鉴别诊断，特别是要区分真性和假性进展。
