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First Author: N.Kasetsuwan THAILAND
Co Author(s): U. Reinprayoon P. Chantaren
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To present a typical case of syphilitic interstitial keratitis with retrocorneal scrolls and the characteristic findings in anterior segment investigations.
Cornea and refractive surgery unit, Department of Ophthalmology, King Chulalongkorn memorial hospital, Bangkok, Thailand
A case report
A 64 year-old female with remote history of syphilitic infection presented with band keratopathy and the typical retrocorneal scrolls. Her spectacle corrected visual acuity was 20/50 in right eye, 20/30 in left eye. The specular microscope showed decreased endothelial cell density, pleomorphism, polymegathism and hyperreflective fibrocellular rods. The anterior segment optical coherent tomography (AS-OCT) and the ultrasound biomicroscopy (UBM) also demonstrated the rod-shaped retrocorneal scrolls protruding from Descemets membrane into the anterior chamber. There were also the iris nodules and whitish membranes along the papillary margin. The patients vision remained stable with her myopic correction for decades without the need for corneal transplantation.
We present a typical case of syphilitic interstitial keratitis with characteristic retrocorneal scrolls, which is currently rarely found. More investigations such as AS-OCT, UBM and confocal microscopy are helpful in demonstrating these abnormalities. Moreover, these findings are also useful in preoperative evaluations to prevent intraocular complications.