Conjunctival-corneal melt in association with carotid artery stenosis

Stewart, Rosalind M K; Quah, Say Aun; Nguyen, Dan Q; Kaye, Stephen B.

doi:10.2147/opth.s2430

Cited by 7 publications

(4 citation statements)

References 10 publications

(9 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of note, this patient was diagnosed with Moyamoya disease during this admission after his brain MRI showed marked stenosis and irregularity of bilateral intracranial internal carotid arteries and bilateral anterior cerebral arteries. While unclear what role, if any, this may have contributed in the development of his descemetoceles, there have been reports of carotid artery stenosis leading to corneal and scleral melts 10 , 11 . Ultimately, multiple underlying factors may have led to an increased susceptibility to epithelial and stromal degradation in this patient.…”

Section: Discussionmentioning

confidence: 84%

Severe bilateral descemetoceles in Alpha-1 antitrypsin deficiency

Baqai

2019

American Journal of Ophthalmology Case Reports

View full text Add to dashboard Cite

Purpose To report a case of severe bilateral descemetoceles in a patient with alpha-1 antitrypsin (A1AT) deficiency during intensive care unit hospitalization. Observations A 42-year-old male presented with sub-acute bilateral vision loss during an intensive care unit hospitalization following liver and kidney transplantations. On exam, this patient's best-corrected visual acuity was 20/80 in both eyes. There were bilateral descemetoceles inferotemporally in both eyes with overlying epithelial defects and dense surrounding punctate epithelial staining. The patient was initially treated with gatifloxacin drops and frequent lubricating ointment. Given the concern for impending perforation, cyanoacrylate glue with bandage contact lens was applied to both eyes. His best corrected visual acuity remained unchanged in the right eye and improved to 20/30 in the left eye. Upon medical stabilization, anterior lamellar graft was performed in the right eye, with plans for the same treatment in the left eye in the future. Conclusions As A1AT is found in the tear film and is believed to play a role in regulating protease activity in the cornea, we hypothesize that this patient's A1AT deficiency exacerbated the progression of corneal ulceration leading to severe descemetocele formation.

show abstract

Section: Discussionmentioning

confidence: 84%

Severe bilateral descemetoceles in Alpha-1 antitrypsin deficiency

Baqai

2019

American Journal of Ophthalmology Case Reports

View full text Add to dashboard Cite

show abstract

“…Further, this melting can be caused by a delayed-onset hypersensitivity response to localized ischemia that involves the episcleral blood vessels. [3][4][5] With respect to surgeries, it is reported mostly after pterygium surgery with bare sclera technique, particularly in cases where adjunctive radiation or chemotherapy is used. [6][7][8][9][10][11][12][13][14][15] MMC acts as an alkylating agent and a potent fibroblast inhibitor, which can cause irreversible damage to the cell.…”

Section: Discussionmentioning

confidence: 99%

Scleral thinning after eye-whitening surgery

Ide

Ichihashi²,

Toda

et al. 2015

Asian JO

View full text Add to dashboard Cite

We report the case of a 32-year-old male patient who presented with conjunctival redness after multiple bilateral eye-whitening surgeries. Slit-lamp examination revealed scleral melting, avascular areas, and demarcation lines in both eyes. Considering the treatment history and the clinical findings of the patient, we conclude that the removal of the conjunctiva and Tenon’s layer and use of mitomycin C is not desirable for a healthy ocular surface.

show abstract

“…If the limbal vascular routes are no longer functional because of massive thrombosis, then the integrity of the cornea is threatened and sterile necrosis leading to a melt syndrome may occur. 8 Akpek et al 9 discovered that the body can launch an attack on cornea-associated antigen, located only in the cornea, which can also lead to corneal melt.…”

Section: Discussionmentioning

confidence: 99%

The CT Appearance of a Corneal Melt: Report of 2 Cases

Bluestone¹,

Ackert²,

Som³

2011

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

SUMMARY:When the cornea of the eye dissolves, most commonly secondary to infection or trauma, the ventral wall of the anterior chamber of the eye is no longer supported and thus bulges forward, enlarging the anterior chamber volume. This is referred to as a corneal melt, and it has a unique CT appearance that has not been previously described.A corneal melt is a complete breakdown of the corneal structure, which can be initiated by a variety of conditions most commonly related to infections, prior surgery, systemic or localized autoimmune diseases, or trauma. When a corneal melt occurs, it results in an enlarged anterior chamber of the eye and it has a unique CT morphology, which does not appear to have been previously described, to our knowledge. The purpose of this article is to report 2 cases of corneal melt: 1 related to herpes simplex infection and 1 related to trauma after cataract surgery and a corneal transplant. Case Reports Case 1The patient was a 51-year-old man with no significant medical history. His ocular history was significant for herpetic keratitis treated at an outside institution. The patient reportedly had a neurotrophic ulcer secondary to herpetic eye disease, which he said resolved 4 months earlier. Approximately 3 months before his present admission, he noted progressively worsening vision associated with ocular pain. At the time of presentation, he had no light perception in the right eye and was 20/40 in the left eye. He was noted to have a tension of 76 in the affected eye. The anterior segment of the eye was disorganized with opacification, and no corneal layers could be identified. There was no view to the posterior pole. On B-scan sonography, the retina was flat without any significant vitritis. The lens was noted to be thickened and slightly displaced anteriorly. A CT scan of the orbits showed a grossly enlarged anterior chamber in an otherwise unremarkable eye (Fig 1). Five days later, the patient had an enucleation of the right eye. Case 2The patient was a 90-year-old woman with a medical history significant for migraines and gait imbalance, and an ocular history significant for bilateral cataract extractions 20 years ago and corneal transplantation in the left eye 9 years ago, with a limbal relaxing incision performed 1 year later for a residual refractive error. On presentation to the emergency department for a fall, she had decreased vision in her left eye, and an examination revealed multiple facial lacerations. Her ophthalmic examination showed a flat anterior chamber with prolapsed uveal tissue. Her CT of the head and orbits showed no evidence of acute orbital fracture. However, there was an enlarged anterior chamber in her left eye (Fig 2). After appropriate antibiotic and tetanus vaccine prophylaxis, she was taken to the operating room where it was found that her corneal transplant wound had dehisced and the intraocular lens placed at the time of cataract surgery had extruded from the eye and was found in the inferior fornix. DiscussionThe corneal epithelium is important ...

show abstract

Conjunctival-corneal melt in association with carotid artery stenosis

Cited by 7 publications

References 10 publications

Severe bilateral descemetoceles in Alpha-1 antitrypsin deficiency

Severe bilateral descemetoceles in Alpha-1 antitrypsin deficiency

Scleral thinning after eye-whitening surgery

The CT Appearance of a Corneal Melt: Report of 2 Cases

Contact Info

Product

Resources

About