Spontaneneous hydrops in pellucid marginal degeneration: documentation by OCT‐III

Abstract

Corneal pellucid marginal degeneration (PMCD) is an idiopathic condition characterized by non-inflammatory, non-ulcerative thinning of inferior peripheral cornea. PMCD has been reported occasionally complicated with hydrops owing to break in descemet membrane. We herein report a 38-year-old man, who presented with sudden dimness of vision in right eye. Clinical findings and Orbscan II were suggestive of PMCD in both eyes with hydrops in right eye. Slit-lamp and optical coherence tomography of right eye showed central descemet's detachment without any break. Patient underwent descemetopexy by isoexpansile C3F8 (14%) and is doing well with significant improvement in the hydrops.

Anterior Segment Optical Coherence Tomography Features of Acute Corneal Hydrops

“…ASOCT features of acute hydrops have been described earlier in 2 cases of pellucid marginal corneal degeneration and 1 case of keratoconus. 8,12,13 Isolated DM detachment without a break was also observed by Ramamurthy et al 8 Although this unusual finding questions our present understanding of the mechanism of corneal hydrops, a small planar DM break could also have been missed by the ASOCT scans, which are taken at 45-degree intervals. Nakagawa et al 14 used an ultrasound biomicroscope to study 13 eyes with acute corneal hydrops and noted intrastromal clefts and DM breaks in all eyes.…”

“…7 Encouraged by our initial results, we offered this treatment modality to all patients who subsequently presented to us with acute corneal hydrops. 8,15 In patients who consented to undergo this procedure, it was performed by a single surgeon (P.K.V.) under topical or general anesthesia in the main operating room with all aseptic precautions.…”

Posterior corneal morphological changes in primary congenital glaucoma

“…The other plausible etiology could be a tractional detachment, wherein elasticity disparity between anterior and posterior corneal layers (DM/PDL complex) causes failure of posterior corneal layers to stretch, examples of which have been seen as “isolated DM detachments” without break in adults with corneal hydrops. [ 15 16 ] Similar findings have been reported in a case of forceps-associated corneal injury in a neonate. [ 17 ]…”