Wydanie 3/2012
str. 15

Ostry stożek rogówki w obrazie optycznej koherentnej tomografii odcinka przedniego – opis przypadku

Imaging of Acute Keratoconus in Anterior Segment Optical Coherence Tomography – Case Report

Ewa Pieczara1, Maria Formińska-Kapu¶cik1,2, Piotr Go¶ciniewicz3, Tomasz Wilczyński3

1 Oddział Okulistyki Dziecięcej Samodzielnego Publicznego Szpitala Klinicznego nr 5 ¦l±skiego Uniwersytetu Medycznego w Katowicach
Kierownik: prof. dr hab. n. med. Maria Formińska-Kapu¶cik
2 Klinika Okulistyki Dziecięcej Katedry Okulistyki ¦l±skiego Uniwersytetu Medycznego w Katowicach
Kierownik: prof. dr hab. n. med. Maria Formińska-Kapu¶cik
3 Katedra i Klinika Okulistyki ¦l±skiego Uniwersytetu Medycznego w Katowicach
Oddział Okulistyki Dorosłych Samodzielnego Publicznego Szpitala Klinicznego nr 5
¦l±skiego Uniwersytetu Medycznego w Katowicach
Kierownik: prof. dr hab. n. med. Wanda Romaniuk

Summary: Purpose: Acute keratoconus (hydrocele, hydrops) is caused by Descemet membrane rupture. The aqueous penetrating the membrane causes massive stromal and epithelial oedema. Eye pain, extensive lacrimation, irritation, photophobia and visual acuity reduction are usually present. Acute keratoconus occurs in 2.6–5% of all of keratoconus cases, from which 9.1% is in children. It is more often observed in people with Down syndrome, mental retardation, atopy, allergy which is an effect of long term eye rubbing.
In the paper we present course and imaging of the acute keratoconus in anterior segment optical coherence tomography (AS – OCT ) in a 17-years old boy with mental retardation.
Material and Methods: Patient was sent to the hospital with symptoms of strong eye pain, extensive lacrimation, photophobia and visual acuity reduction in the left eye.
His central corneal thickness (CCT) in AS OCT VISANTE in the left eye with acute keratoconus was 1570 mm. CCT in the right eye without keratoconus was 480 mm. He had undergone trabeculectomy with amniotic membrane graft in left eye.
Results: After the surgery corneal flattening, increase in its transparency and alleviation of pain were achieved. Three weeks after treatment CCT in the left eye was 280 mm and after one year 320 mm.
Conclusions: AS – OCT is a valuable addition to diagnosis of acute keratoconus, to monitor its progress and evaluation of therapeutic effects even in patients with mental retardation. Trabeculectomy with amniotic membrane graft is a rapid, effective and safe treatment for acute keratoconus in children with mental retardation.

Słowa kluczowe: ostry stożek rogówki, optyczna koherentna tomografia odcinaka przedniego, dzieci z niedorozwojem umysłowym.

Keywords: Key words: acute keratoconus, AS – OCT, children with mental retardation.


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