Roszkowska Anna M, Azzaro Claudia, Calderone Alessandro, Spinella Rosaria, Schiano-Lomoriello Domenico, Mencucci Rita, Wylęgała Adam
Ophthalmology Clinic, Department of Biomedical Sciences, University Hospital of Messina, 98124 Messina, Italy.
Ophthalmology Department, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland.
J Clin Med. 2024 Aug 20;13(16):4900. doi: 10.3390/jcm13164900.
This review aimed to evidence the predisposing conditions for Salzmann nodular degeneration (SND), where particular attention was paid to its association with ocular and systemic diseases. SND is a rare disease characterized by bluish-white nodules located in the mid-periphery of the cornea, which are otherwise completely clear. SND has been found in association with different systemic and ocular diseases, and it may have unilateral or bilateral presentation. Initial forms are only diagnosed occasionally as they are asymptomatic, whereas, in advanced disease, the visual acuity might be seriously impaired. Although SND is well described, its exact etiopathology is currently still unknown and is frequently misdiagnosed. It is associated with ocular surface inflammatory conditions and previous corneal surgery, and it has been described in different systemic diseases. Diagnosis is clinically based with slit lamp examinations, and instrumental assessments with corneal topography permit one to observe the alterations of the corneal profile, whereas anterior segment-optical coherence tomography (AS-OCT) is used to investigate the stromal depth of the nodules. Therapy might be conservative with the objective of improving the ocular surface homeostasis and surgical outcomes, where the aim is to restore the corneal regularity and visual acuity. Ophthalmologists should pay particular attention when detecting nodules in patients with ocular and non-ocular inflammatory diseases to guarantee the patient a timely diagnosis and a better therapeutic outcome. Additionally, collaboration between specialists who deal with treating patients suffering from disorders potentially associated with SND is recommended.
本综述旨在证实萨尔茨曼结节性变性（SND）的诱发因素，特别关注其与眼部和全身性疾病的关联。SND是一种罕见疾病，其特征为角膜中外周出现蓝白色结节，而角膜其他部位完全透明。已发现SND与不同的全身性和眼部疾病有关，可单侧或双侧发病。初期形式因无症状而仅偶尔被诊断出来，而在疾病晚期，视力可能会严重受损。尽管SND已有详尽描述，但其确切病因病理目前仍不清楚，且经常被误诊。它与眼表炎症状况及既往角膜手术有关，并且在不同的全身性疾病中也有描述。诊断基于裂隙灯检查，角膜地形图的仪器评估可观察角膜轮廓的改变，而眼前节光学相干断层扫描（AS - OCT）则用于研究结节的基质深度。治疗可能是保守的，目的是改善眼表稳态和手术效果，目标是恢复角膜规则性和视力。眼科医生在检测患有眼部和非眼部炎症疾病的患者中的结节时应格外注意，以确保患者得到及时诊断和更好的治疗效果。此外，建议处理可能与SND相关疾病患者治疗的专家之间开展合作。
