Bilateral Infectious Ulcers Associated With Atopic Keratoconjunctivitis

Abstract

Bilateral infectious ulcers with perforation are a rare and severe complication of atopic keratoconjunctivitis. HRT II-RCM in vivo confocal microscopy imaging is useful in monitoring the progression of ocular surface diseases.

Corneal Confocal Microscopy in Patients with Vernal Keratoconjunctivitis

“…Confocal microscopy is a rapid, noninvasive, high-resolution technique used to investigate in vivo the morphologic features of normal and patho- logic human corneas. Most studies have been involved in evaluating corneal structures after local or systemic diseases, such as diabetes, dry eye, herpetic and acanthamoeba keratitis, keratoconus, refractive surgery procedures, [22][23][24][25][26][27][28][29] and recently, atopic keraconjunctivitis, 30 superior limbic keraconjunctivitis, 31 and allergic reactions. 32 Corneal involvement in VKC is considered a superficial epitheliopathy that can worsen in the presence of superficial sterile ulcers and aspecific hypersensitivity resulting from changes in corneal sensitivity and epithelial alterations.…”

Allergic Conjunctivitis and Latent Infections

“…Severe corneal ulcers and keratitis secondary to fungal and bacterial infection have been reported in cases of vernal and atopic keratoconjunctivitis. [10][11][12][13] The presence of a latent infection could be the first step in the development of these severe corneal complications.…”

In Vivo Corneal Confocal Microscopy in Marfan Syndrome

“…8 On the basis of the above-mentioned involvement of the cornea in Marfan syndrome and with the advent of new-generation in vivo corneal confocal microscopy, corneas of patients with Marfan syndrome were examined with the in vivo confocal microscope Heidelberg Retina Tomograph (HRT) II/Rostock Cornea Module (RCM; Heidelberg Engineering, Heidelberg, Germany), a high-resolution device we already use to assess corneal ulcers of filtering blebs after glaucoma surgery, 9,10 to study corneal pathologic characteristics. A control group of healthy corneas of volunteer subjects was also examined by using the same in vivo technology to reliably study corneal changes in Marfan disease at a histologic-like level.…”