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First Author: E.Demirkilinc TURKEY
Co Author(s): S. Guven Yilmaz M. Palamar
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To report confocal microscopy, corneal topography, pachymetry and optic coherence tomography findings of a 50 year-old male with ocular ochronosis.
Ege University Faculty of Medicine, Ophthalmology Department
Complete ophthalmologic examination, including confocal microscopy (Heidelberg Retina Tomograph II attached Rostoch module), corneal topography and pachymetry (Pentacam), anterior segment photography, and optical coherence tomography (OCT) were performed.
Best corrected visual acuity were 0.4 in both eyes. Biomicroscopic examination showed bilateral dark pigmentation in nasal and temporal conjunctiva, and episclera. Fundus examination in both eyes revealed tilted optic discs and peripapillary atrophy. Corneal topography, pachymetry, and OCT were bilaterally normal. Confocal microscopy of the lesions revealed prominent degenerative changes including vacuoles and fragmentation in the elastic fibers of the affected conjunctival substantia propria and episclera. Hyperreflective pigment granules were also shown between the elastic fibers of conjunctival substantia propria.
The degenerative changes due to ochronotic pigment deposits can be detailly demonstrated with confocal microscopy. Hence, confocal microscopic analysis in ocular ochronosis may serve as a useful adjunct in diagnosis and monitoring of disease progression.