International Journal of Keratoconus and Ectatic Corneal Diseases

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VOLUME 8 , ISSUE 2 ( July-December, 2019 ) > List of Articles

CASE REPORT

A Case of True Superior Keratoconus Confirmed Using Multiple Imaging Modalities

Onur Özalp, Eray Atalay, Nilgün Yıldırım

Keywords : Anterior segment optical coherence tomography, Epithelial thickness, Superior keratoconus, Tomography, Topography

Citation Information : Özalp O, Atalay E, Yıldırım N. A Case of True Superior Keratoconus Confirmed Using Multiple Imaging Modalities. Int J Kerat Ect Cor Dis 2019; 8 (2):43-45.

DOI: 10.5005/jp-journals-10025-1180

License: CC BY-NC 4.0

Published Online: 22-02-2021

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: To report an unusual case of a newly diagnosed bilateral superior keratoconus in an elderly patient. Background: We report a case of bilateral superior keratoconus in a 64-year-old woman who was diagnosed after having presented with hydrops in one eye. Case description: Uncorrected visual acuity was counting fingers from 3 and 1 meter for the right and left eyes, respectively. A superiorly located deep stromal scar and chronic corneal edema consistent with a diagnosis of corneal hydrops were noted for the left eye. Although the cornea was clear, there was superior corneal protrusion in the right eye. Pentacam and Orbscan demonstrated overlapping focal corneal thinning, increased back elevation, and steepening in the superior cornea. Anterior segment optical coherence tomography (AS-OCT) showed stromal and epithelial thinning in the superior cornea and significant compensatory epithelial thickening in the opposing quadrant. In light of these findings, a diagnosis of superior keratoconus was established. Conclusion: Superior keratoconus is a rare condition. Meticulous evaluation of corneal tomography and epithelial thickness profile is crucial for localizing the superior cone in keratoconus. Clinical significance: This is the first case report demonstrating epithelial thickness profile in a superior keratoconus case.


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  1. Bilateral superior keratoconus: two case reports. Eye (Lond) 2014;28(10):1254–1257. DOI: 10.1038/eye.2014.146.
  2. Superior keratoconus. Cornea 1997;16(6):693–694.
  3. Superior keratoconus. Refract Corneal Surg 1993;9(5):394–395. DOI: 10.3928/1081-597X-19930901-15.
  4. Atypical unilateral superior keratoconus in young males. Cont Lens Anterior Eye 2005;28(4):177–179. DOI: 10.1016/j.clae.2005.10.002.
  5. Superior keratoconus with hydrops. Int Ophthalmol 2009;29(5):419–421. DOI: 10.1007/s10792-008-9244-0.
  6. Blepharoptosis-induced superior keratoconus. Am J Ophthalmol 2000;130(2):232–234. DOI: 10.1016/s0002-9394(00)00497-9.
  7. Superior keratoconus with inferior paracentral corneal thinning and inferior peripheral pellucid marginal degeneration. Eye (Lond) 2007;21(2):266–268. DOI: 10.1038/sj.eye.6702507.
  8. Idiopathic superior keratectasia with spontaneous perforation treated with amniotic membrane transplantation. Eye Contact Lens 2008;34(4):242–243. DOI: 10.1097/ICL.0b013e31816476f2.
  9. Understanding elevation based topography: how elevation data is displayed. In: Belin MW, Khachikian SS, Ambrosio R, editors. Elevation Based Corneal Tomography. New Delhi, India: Jaypee Brothers, Medical Publishers Pvt. Limited; 2012. pp. 25–46.
  10. Diagnosing keratoconus using VHF digital ultrasound epithelial thickness profiles. In: Alió JL, editor. Keratoconus: Recent Advances in Diagnosis and Treatment. Cham: Springer International Publishing; 2017. pp. 151-66.
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