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First Author: C.Malhotra INDIA
Co Author(s): A. Jain
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To correlate the morphological lesions of corneal dystrophies seen on slit lamp biomicroscopy with images obtained by CM.
Tertiary care ophthalmology centre in North India
In vivo CM using the HRT III Rostock Cornea module was done for patients having epithelial basement membrane dystrophy (EBMD) , granular dystrophy and macular dystrophy and Fuchsendothelial dystrophy (FED) .
In EBMD predominantly three types of lesions were seen on CM at the level of the basal epithelium and wing cells: (i)multiple ,round, hyper reflective dots in various stages of coalescence with central clear spaces (ii) Broad map like areas of hyperreflective material (iii) Reduplicated basement membrane protruding into the epithelial layers.. In macular dystrophy hyperreflective deposits with fuzzy ill defined margins were seen at all depths in the corneal stroma along with a marked lack of stromal keratocytes . In granular dystrophy hyperreflective deposits with well delieanated margins were seen limited mainly to the anterior stroma. Stromal keratocytes were visualized normally. In FED strawberry like appearance of guttae- i.e dark areas with single or multiple central bright spots were visualized.
In vivo CM is a powerful tool to image the corneal changes in different types of dystrophies as lesions characteristic of each disorder can be identified. This can be specially useful in classifying dystrophies in those cases where the clinical picture may overlap .