Lattice-Like Band Keratopathy: Retinopathy Of Prematurity Sequalae Masquerading As Lattice Corneal Dystrophy

Published 2026 - 44th Congress of the ESCRS

Reference: POCOR025 | Type: Case Report | DOI: 10.82333/v1cq-rk41

Authors: Dr Brian Armstrong ¹ , Dr Brandon Vander Zee* ¹

¹Ophthalmology,Truhlsen Eye Institute,Omaha,United States

Purpose

To present a diagnostic challenge in a 16‑year‑old female with decreased vision and bilateral lattice‑like corneal deposits who was initially suspected to have lattice corneal dystrophy. Further evaluation ultimately confirmed the diagnosis to be band keratopathy, likely secondary to prior laser treatment for retinopathy of prematurity (ROP). This case underscores the importance of integrating ocular history, genetic testing, and targeted literature review to avoid misdiagnosis and guide appropriate management. Before‑and‑after corneal photographs will be shown, with guardian consent obtained for image use.

Setting

This patient was evaluated and treated at a university-associated tertiary care center in the United States.

Report of case

A 16‑year‑old girl with a history of bilateral laser‑treated ROP was referred for decreased vision and evaluation for presumed corneal dystrophy. Best corrected visual acuity measured 20/40 OD and 20/40‑1 OS with high myopic astigmatism OU. Slit‑lamp exam revealed bilateral central linear white superficial subepthelial opacities resembling lattice corneal dystrophy. Fundus examination showed bilateral 360° chorioretinal scarring consistent with prior extensive peripheral retinal laser.

Because the pattern resembled lattice dystrophy, an Invitae corneal dystrophy genetic panel was obtained and returned negative. Re‑evaluation of the patient's history prompted a literature review, including a report describing band keratopathy occurring in patients with prior laser treatment for ROP. This raised the possibility that her lattice‑like corneal deposits represented calcific deposition rather than a hereditary dystrophy.

Laboratory studies and a detailed review of symptoms revealed no metabolic or inflammatory cause for band keratopathy. Bilateral sequential EDTA corneal chelation was performed, resulting in complete resolution of the deposits. Post‑procedure, her vision improved to 20/25 OU, with marked symptomatic improvement.

Conclusion/Take home message

Band keratopathy can mimic lattice corneal dystrophy, particularly in patients with a prior history of laser‑treated ROP. Recognizing this association is essential to avoid misdiagnosis, unnecessary genetic testing, and inappropriate management. This case illustrates the importance of correlating ocular history with atypical corneal findings and demonstrates that EDTA chelation can rapidly restore visual clarity when band keratopathy is correctly identified and treated.