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Electronic Poster Presentations
Purpose: A 69-year-old patient on a therapy against rheumatoid arthritis (of 15 years’ duration) was presented to us complaining of a sudden visual acuity decrease and pain in his right eye.
SETTING: Departament of Ophthalmology, Medical University of Silesia in Katowice, Poland.
METHODS: Slit-lamp microscopy revealed intensive mixed injection in the eye, focal scleromalacia and peripheral keratomalacia with perilimbal perforation (starting at 1 to 6 o’clock position), incarcerated iris, and early-stage cataract. The left eye showed peripheral linear infiltrations (6 to 11 o’clock position). The patient was hospitalised and anti-inflammatory therapy was launched as agreed with a rheumatologist (collagenase inhibitors and immunomodulatory agents). Surgical dressing was applied onto the corneal defect in the right eye; conjunctival recession from the limbus was also performed. Therapeutic contact lenses were used in both eyes.
RESULTS:Scanning confocal microscopy was performed of the right and left and corneas, and revealed the following: right eye – centrally: pleomorphism and polymegatism of the endothelial cells; few active keratocytes, deposits, and inflammatory cells within the stroma; excessive desquamation of the superfiitial epithelial cells. At the periphery: cicatrical tissue of high reflectivity, numerous active keratocytes. In the left eye the examination detected- centrally: pleomorphism and polymegatism of the endothelial cells; numerous deposits and active keratocytes within the stroma; excessive desquamation of the of the superfiitial epithelial cells and few blister-like structures. At the periphery: limited areas of high reflectivity.
CONCLUSIONS: The treatment resulted in clinical improvement and is continued in the outpatient clinic.
I. Rokita-Wala, S. Gierek-Ciaciura, E. Mrukwa-Kominek,
POLAND
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