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Case report: peripheral hypertrophic subepithelial degeneration

Poster Details

First Author: M.Marques PORTUGAL

Co Author(s):    C. Rodrigues   M. Leitão   R. Silva   S. Alves           

Abstract Details


To present a case of peripheral hypertrophic subepithelial degeneration (PHSD) of the cornea. This condition, first described in 2003, is a typically bilateral and slowly progressive perilimbal disorder with associated symptoms of ocular irritation, together with the absence of preceding keratitis.It may represent a variant of Salzmann nodular degeneration.


Case Report, Instituto de Oftalmologia Dr. Gama Pinto


A patient with peripheral hypertrophic subepithelial degeneration of the left cornea was followed up for a year. This 24-year-old male experienced a progressive decrease in visual acuity for the last 6 years and mild nonspecific ocular discomfort. The best spectacle corrected visual acuity was 8/10 in the right eye and 2/10 in the left eye. Slit-lamp examination demonstrated unilateral nasal and temporal fibrotic subepithelial peripheral corneal lesions in his left eye. Corneal subepithelial thickening and the loss of corneal transparency were clearly visible in the OCT images in the form of increased corneal reflectance.


Superficial keratectomy was performed and resulted in improvement of best spectacle-corrected visual acuity. The diagnosis was confirmed by histopathological analysis of the surgical piece.


The patient meets most of the diagnostic criteria proposed in previous articles (perilimbal subepithelial fibrosis with a thickened cornea, neovascularization, 2 D or more of astigmatism with regular or irregular topography), although he also presented with some less-typical features, such as unilateral disease and male gender. This case report may thus contribute to expand the phenotypical spectrum of a disease that has rarely been described in the literature or textbooks.

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