一名儿科患者的暂时性圆锥角膜
Temporal keratoconus in a pediatric patient.
作者信息
Zhang Lyvia J, Traish Aisha S, Dohlman Thomas H
机构信息
Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
Cornea Service, Boston Children's Hospital, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
出版信息
Am J Ophthalmol Case Rep. 2023 Jul 22;32:101900. doi: 10.1016/j.ajoc.2023.101900. eCollection 2023 Dec.
PURPOSE
To report a pediatric patient with bilateral temporal keratoconus.
OBSERVATIONS
A 14-year-old male presented with a two-year history of progressively worsening visual acuity in both eyes and suspicion for undiagnosed amblyopia in the right eye. Retinoscopy revealed a scissoring reflex in both eyes and corneal topography demonstrated high keratometry values (Kmax 57.9 D and 46.1 D in the right and left eyes, respectively), with relative temporal steepening approximately coinciding with the thinnest pachymetry in both eyes. Corneal cross-linking was recommended.
CONCLUSIONS AND IMPORTANCE
Keratoconus can present as a temporal variant with relative temporal steepening and thinning. It is important to maintain a high index of suspicion for keratoconus in pediatric patients with sub-normal visual acuities. Prompt assessment and diagnosis may prevent progression of keratoconus and development of amblyopia.
目的
报告一例双侧颞侧圆锥角膜的儿科患者。
观察结果
一名14岁男性，双眼视力进行性下降两年，右眼疑似存在未确诊的弱视。检影显示双眼有剪动反射，角膜地形图显示角膜曲率计值较高（右眼和左眼的最大角膜曲率分别为57.9 D和46.1 D），相对颞侧陡峭程度大致与双眼最薄的角膜厚度测量值一致。建议进行角膜交联术。
结论及重要性
圆锥角膜可表现为相对颞侧陡峭和变薄的颞侧变异型。对于视力低于正常的儿科患者，高度怀疑圆锥角膜很重要。及时评估和诊断可预防圆锥角膜进展和弱视的发生。
Zotero 插件