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OPHTHALMIC IMAGE
Year : 2021  |  Volume : 1  |  Issue : 4  |  Page : 858

Unusual hydrops - Superiorly located and Descemet's membrane tear away from thin area


Sankara Nethralaya, Medical Research Foundation, New No. 41 (Old No. 18) College Road, Nungambakkam, Chennai, Tamil Nadu, India

Date of Web Publication09-Oct-2021

Correspondence Address:
Dr. Radhika Natarajan
Sankara Nethralaya, Medical Research Foundation, New No. 41 (Old No. 18) College Road, Nungambakkam, Chennai- 600 006, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_3231_20

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How to cite this article:
Natarajan R, Balaji J J, Matai HD. Unusual hydrops - Superiorly located and Descemet's membrane tear away from thin area. Indian J Ophthalmol Case Rep 2021;1:858

How to cite this URL:
Natarajan R, Balaji J J, Matai HD. Unusual hydrops - Superiorly located and Descemet's membrane tear away from thin area. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Oct 26];1:858. Available from: https://www.ijoreports.in/text.asp?2021/1/4/858/327668



Acute hydrops in keratoconus or pellucid marginal degeneration (PMD) occurs due to Descemet's membrane (DM) rupture in the area of maximum thinning.[1] This could be in the central or inferotemporal cornea in keratoconus and inferior in PMD.[2]

Our patient, an eye rubber, had these findings reversed on two counts. As shown in [Figure 1], the DM rupture and hydrops occurred unusually in the superior cornea. Also, it was away from the discretely thinnest, perilimbal non-edematous area, located inferiorly. The possible explanation is a combination of PMD and keratoconus, as the fellow eye showed central Vogt's striae as well as features of PMD on tomography.[3]
Figure 1: Composite picture showing (a) Superior DM rupture and hydrops, (b) Anterior segment optical coherence tomography (AS-OCT) image of the same, (c) AS-OCT showing the thinnest area in the inferior cornea, (d) Slit section showing DM rupture and hydrops away from the thinnest area. Yellow arrows point to the hydrops and pink arrows to the thinnest area. The blue circle denotes the area of edema within and non-edematous cornea outside

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Krachmer JH, Feder RS, Belin MW. Keratoconus and related noninflammatory corneal thinning disorders. Surv Ophthalmol 1984;28:293-322.  Back to cited text no. 1
    
2.
Koc M, Tekin K, Inanc M, Kosekahya P, Yilmazbas P. Crab claw pattern on corneal topography: Pellucid marginal degeneration or inferior keratoconus? Eye (Lond) 2018;32:11-8.  Back to cited text no. 2
    
3.
Kayazawa F, Nishimura K, Kodama Y, Tsuji T, Itoi M. Keratoconus with pellucid marginal corneal degeneration. Arch Ophthalmol 1984;102:895-6.  Back to cited text no. 3
    


    Figures

  [Figure 1]



 

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