Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD. Dr. Shifera is now with the private practice in Zephyrhills, FL.
Cornea. 2022 May 1;41(5):644-646. doi: 10.1097/ICO.0000000000002810.
The purpose of this study was to present a case of diffuse noncaseating granulomas involving the corneal stroma in a patient with ocular and pulmonary sarcoidosis.
This was a single case report.
A 31-year-old female patient presented with a 6-year history of panuveitis of the right eye along with a history of pulmonary sarcoidosis and a conjunctival biopsy of the right eye that was reported as positive for sarcoidosis. At presentation to our clinic, the patient had band keratopathy, vascularization of the inferonasal cornea, and active anterior uveitis of the right eye. When the patient returned for a follow-up of 15 months after the initial presentation, the cornea of the right eye exhibited widespread stromal scarring and vascularization. Because of the corneal scarring, the patient underwent an implantation of a Boston type 1 keratoprosthesis in the right eye. Histopathological examination of the host corneal tissue removed at the time of the keratoprosthesis procedure revealed extensive noncaseating granulomas in the deep corneal stroma. The patient underwent penetrating keratoplasty 8 months later, and histopathological examination again demonstrated noncaseating granulomas, this time at the edges of the donor corneal graft used during the keratoprosthesis implantation.
We present the histopathological evidence of sarcoidosis involving the corneal stroma. Interestingly, the stromal keratitis also subsequently involved the donor cornea tissue after the patient underwent a keratoprosthesis implantation. It seems that sarcoidosis is a rare cause of stromal keratitis.
本研究旨在报告一例累及角膜基质的弥漫性非坏死性肉芽肿患者，该患者同时患有眼和肺结节病。
这是一个单一病例报告。
一名 31 岁女性患者因右眼全葡萄膜炎就诊，病史包括肺结节病和右眼结膜活检阳性的结节病。患者就诊时右眼出现带状角膜病变、鼻下方角膜血管化和右眼活动性前葡萄膜炎。初次就诊 15 个月后，患者右眼出现广泛的基质瘢痕和血管化。由于角膜瘢痕，患者右眼行 Boston 1 型角膜移植术。在角膜移植术时切除的宿主角膜组织的组织病理学检查显示深层角膜基质中存在广泛的非坏死性肉芽肿。8 个月后，患者行穿透性角膜移植术，再次在用于角膜移植术的供体角膜移植边缘处的组织病理学检查中发现非坏死性肉芽肿。
我们提出了累及角膜基质的结节病的组织病理学证据。有趣的是，在患者行角膜移植术之后，角膜基质炎也随后累及供体角膜组织。结节病似乎是一种罕见的基质性角膜炎的病因。
