Infectious crystalline keratopathy histopathological characteristics

Christakopoulos, Christos; Prause, Jan Ulrik; Heegaard, Steffen

doi:10.1046/j.1600-0420.2003.0169.x

Cited by 14 publications

(13 citation statements)

References 6 publications

(4 reference statements)

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“…Christakopoulos et al investigated the difference between infectious keratitis and ICK, and identified an impairment in complement mediated phagocytosis and inflammatory cell recruitment in ICK cases 10. This was thought to be attributable to a biofilm produced by the microorganisms in ICK.…”

Section: Discussionmentioning

confidence: 99%

Infectious crystalline keratopathy after Descemetâ€™s stripping endothelial keratoplasty

Porter

Lee²,

Whitehead

2017

BMJ Case Reports

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A 68-year-old woman presented with infectious crystalline keratopathy 4 months after she underwent a combined phacoemulsification and Descemet's stripping endothelial keratoplasty for Fuch's endothelial dystrophy in her left eye. After 5 months of topical moxifloxacin 1%, the infiltrate responded well but had not completely resolved, with the resulting endothelial failure requiring a penetrating keratoplasty 9 months after the initial operation. Microbiology identified with the histopathology demonstrating bacterial colonies within the graft interface. Postoperatively she developed endophthalmitis, needing vitrectomy and intravitreal antibiotics. The infection settled with no recurrence, with topical and oral antibiotics continued for 2 months. A sutured toric piggyback intraocular lens was performed 18 months postvitrectomy for graft astigmatism, achieving a best-corrected vision of 6/15.Infectious crystalline keratopathy can occur following Descemet's stripping endothelial keratoplasty, requiring long-term topical therapy and potentially leading to graft failure with the necessity for further keratoplasty.

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Section: Discussionmentioning

confidence: 99%

Infectious crystalline keratopathy after Descemetâ€™s stripping endothelial keratoplasty

Porter

Lee²,

Whitehead

2017

BMJ Case Reports

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“…The colonies of microorganisms found in ICK contain fewer inflammatory cells when compared with colonies found in typical infectious keratitis. 17 It is postulated that this poor recruitment of inflammatory cells may be due to the presence of biofilm in these bacterial colonies. 18 It is possible that some form of therapeutic disruption to the biofilm may provide improved penetration of antibiotics to the bacteria in ICK.…”

Section: Discussionmentioning

confidence: 99%

Laser corneal biofilm disruption for infectious crystalline keratopathy

Masselos

Tsang

Ooi

et al. 2009

Clinical Exper Ophthalmology

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Crystalline keratopathy can be successfully treated by the Nd:YAG laser. We present two cases of crystalline keratopathy managed this way. A 36-year-old female contact lens wearer presented with crystalline keratopathy following recent treatment with topical steroids and antibiotics for a corneal abscess. In this case crystalline keratopathy developed despite the intensive topical antibiotic treatment. A 55-year-old man with a history of acne rosacea, chronic myelomonocytic leukaemia, asthma and Crohn's disease presented with crystalline keratopathy following an episode of infectious keratitis. Treatment with the Nd:YAG laser to the area of involvement was instituted in both cases. Noticeable resolution occurred within days, with subsequent full recovery. No side-effects from the use of the Nd:YAG laser were noted. There have been only two cases previously reported using this treatment modality.

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“…Classically it is characterized by an insidious infiltration of white or grey opacities within the corneal stroma, appearing as stellate or branching fern-like opacities (Figure 1 and 2). 21,48,55,126 Atypically they may develop into amorphous lesions or be associated with satellite lesions that appear to be related to treatment and cessation of topical corticosteroids.…”

Section: A Clinical Presentationmentioning

confidence: 99%

“…Microorganisms form dense colonies within the interlamellar spaces, shaped as distended spindles. 21,46 The colonies dissect the lamellar planes, preserving the structure of adjacent lamella and keratocytes, without necrosis or thinning. 21 Commonly, they are described as confining to a single lamellar plane; however, they can be spread across multiple planes.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Infectious crystalline keratopathy

Porter

Lee

Jun

2018

Survey of Ophthalmology

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Infectious crystalline keratopathy was first reported by Gorovoy and colleagues in 1983 when they identified bacteria colonizing a cornea after a penetrating keratoplasty. Subsequent cases have elaborated on the organisms responsible and the management outcomes. Patients present with a white or gray branching opacity originating from an epithelial defect, commonly after a penetrating keratoplasty. Local immunosuppression contributes to the quiescent nature and the limited inflammatory response associated with infectious crystalline keratopathy. Diagnosis of the infective pathogens may be difficult, with a corneal scraping often being too superficial to obtain an adequate specimen. A biofilm is present that advantages microorganism survival, reduces antibiotic bioavailability, and inhibits diagnostic microbial detection. Treatment begins with topical antimicrobials, initially broad spectrum and then targeted to microorganism sensitivity. Adjunctive therapies to enhance the efficacy of treatment include disruption of the microorganism biofilm by laser, intrastromal antibiotics, and keratectomy. In recalcitrant cases, or where corneal scarring ensues, corneal transplantation is required.

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Infectious crystalline keratopathy histopathological characteristics

Cited by 14 publications

References 6 publications

Infectious crystalline keratopathy after Descemetâ€™s stripping endothelial keratoplasty

Infectious crystalline keratopathy after Descemetâ€™s stripping endothelial keratoplasty

Laser corneal biofilm disruption for infectious crystalline keratopathy

Infectious crystalline keratopathy

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