Diagnosing Congenital Corneal Anesthesia Through T2-Weighted Sequences With High Resolution And Thin Slice Thickness In Infants

Published 2025 - 43rd Congress of the ESCRS

Reference: PO607 | Type: Free paper | DOI: 10.82333/avcc-5r55

Authors: Abdulmajeed Al Khathami, Mbbs ¹

¹Ophthalmology,King FahadHospital, Al Baha Health Cluster,Al Baha,Saudi Arabia

Purpose

To describe radiologic findings in pediatric patients with symptoms of congenital corneal anesthesia (CCA) and to review current literature.

Setting

Ophthalmology Unit at the Schneider Medical Center, Petah Tikva, Israel

Methods

Demographics, clinical characteristics and imaging of all patients with CCA were retrospectively collected and analyzed. All patients underwent brain Magnetic Resonance Imaging (MRI), which showed trigeminal nerve asymmetrical thinning correlated with ipsilateral clinical signs of CCA.

Results

We reviewed four cases of congenital corneal anesthesia. Case 1 (an 11-month-old girl) had a right thinned trigeminal nerve and a hypoplastic right Meckel’s cave. Case 2 (a 1.5-year-old girl) had an MRI scan suggestive of asymmetry in the expected course of the right trigeminal nerve, however, no high resolution T2-weighted sequeneces were acquired and therefore the radiologic diagnosis could not be confirmed Case 3 (a 6-month-old boy) had a hypoplastic right trigeminal nerve, and case 4 (a 9-month-old boy) had bilateral thin trigeminal nerves.

Conclusions

Evaluation of nonverbal children with suspected congenital corneal anesthesia should include brain MRI scan for identification and characterization of the trigeminal nerves. Specifically, high-resolution sequences and thin slice thickness heavily T2- weighted sequences should be acquired in order to assess the entire course of the trigeminal nerves. This can help the treating ophthalmologist to take surgical decisions such as corneal neurotization with more confidence.