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A case of rapidly progressing pellucid marginal degeneration in a patient with underlying orbital pathology

Poster Details

First Author: W.Mayer GERMANY

Co Author(s):    C. Hintschich   D. Kook           

Abstract Details



Purpose:

To report about an unusual progressive case of pellucid marginal degeneration (PMD) in a young patient after orbital debulking surgery due to massive paraffinome formation in the frontal orbital region more pronounced on the left eye after complicated sinus surgery.

Setting:

Case report

Methods:

A 39 year old caucasian with PMD was monitored clinically and topographically for a period of two years.

Results:

Clinical examinations and pentacam analyses showed a marked progression of K values (OD/OS Kmax change: 47.8 to 74.2 / 55.5 to 72.3 dpt) and corneal thinning (OD/OS: 587 to 504 / 569 to 413 ┬Ám) in a two years period. Patient underwent debuckling of orbital paraffinome in the upper and lower lid on the left eye in the meantime and reported about painless visual loss with blurring, discomfort and redness of both eyes. Due to the progression of PMD Corneal Crosslinking was performed.

Conclusions:

Pellucid Marginal Degeneration is a degenerative corneal condition, characterized by a bilateral thinning (ectasia) in the periphery of the cornea. In contrast to keratokonus PMD usually affects patients in their third or fourth decade. The reported case however demonstrates marked progression that might be associated with the underlying orbital disease. We hypothesize, that a transient increase in intraorbital and intraocular pressure could be the pathophysiologic mechanism. FINANCIAL DISCLOSURE?: No

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