Corneal Polyps-Like Lesions: Unusual Aspect Of Descemetic Scarring In Keratoconus

To assess the unusual aspect of descemetic scarring in keratoconus using OCT-SA and pathological analysis .

Habib Bourguiba teaching Hospital - Sfax

We report a case of a 50-year-old female patient with keratoconus of the left eye for many years. Visual acuity on the left was limited to counting fingers of a few centimetres. On the right, corrected visual acuity was 7/10. The slit lamp examination

showed an extensive central corneal opacity on the left, with vascular appeal, corneal protrusion and inferior corneal thinning.

Anterior segment OCT (OCT-SA) images revealed sub-epithelial scars in the form of linear, poorly reflective opacities, a dense sub-epithelial network, a few intrastromal cysts and disorganized disorganized thickening of the stroma with a pseudopolyptic appearance.

Transfixing keratoplasty (TK) was indicated for optical purposes to restore visual acuity.

The cornea was sent for pathological analysis by light microscopy.

OCT findings were consistent with histological findings. In fact, the pathological section showed optically empty lacunae within the stroma,

localized panstromal thickening with a residual appearance of descemetic rupture and dense fibrous remodelling giving the appearance of pseudopolyps visualized on OCT-SA. This dense network of fibrosis indicates the age of the disease.

Keratoconus is a non-inflammatory disease characterized by slowly progressive, idiopathic corneal ectasia.

slowly progressive corneal ectasia. OCT-SA is a non-invasive imaging technique

increasingly used in this pathology, providing high-resolution, quasi-histological

resolution images, enabling highly accurate analysis of tissue changes

tissue changes during the progression of keratoconus.