Bilateral Progressive Idiopathic Annular Lipid Keratopathy

Purpose. To report two unusual cases of idiopathic lipid keratopathy with symmetrical bilateral annular corneal lipid infiltration and describe confocal microscopy findings. Methods. Case reports. Results. We report two patients with bilateral peripheral deep stromal lipid deposits beginning in an a...

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Main Authors: Ramon C. Ghanem, Vinícius C. Ghanem, Gustavo Victor, Milton Ruiz Alves
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Case Reports in Ophthalmological Medicine
Online Access:http://dx.doi.org/10.1155/2012/731413
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author Ramon C. Ghanem
Vinícius C. Ghanem
Gustavo Victor
Milton Ruiz Alves
author_facet Ramon C. Ghanem
Vinícius C. Ghanem
Gustavo Victor
Milton Ruiz Alves
author_sort Ramon C. Ghanem
collection DOAJ
description Purpose. To report two unusual cases of idiopathic lipid keratopathy with symmetrical bilateral annular corneal lipid infiltration and describe confocal microscopy findings. Methods. Case reports. Results. We report two patients with bilateral peripheral deep stromal lipid deposits beginning in an arcuate pattern and progressing to a complete annular shape. Cholesterol crystals were observed in the paracentral area in both cases with characteristic crystalline-like structures in the confocal microscopy. Deep thin corneal blood vessels were observed in one patient, but no cause for then was established, despite decades of followup. This patient had an idiopathic limbitis as well, occurring in episodes. No previous ocular trauma, systemic disease or family history was reported for both cases. Conclusion. These two cases of idiopathic annular lipid keratopathy were observed for more than a decade with documented slow and insidious progression of the infiltrates, in spite of the use of topical steroids in one case. In the majority of other reported cases, a penetrating keratoplasty was made necessary. Differently, we showed that the visual acuity can remain quite good for years with very slow deterioration.
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spelling doaj-art-ffc3734b401b49648bafc99353ca73842025-08-20T03:25:54ZengWileyCase Reports in Ophthalmological Medicine2090-67222090-67302012-01-01201210.1155/2012/731413731413Bilateral Progressive Idiopathic Annular Lipid KeratopathyRamon C. Ghanem0Vinícius C. Ghanem1Gustavo Victor2Milton Ruiz Alves3Department of Cornea and Refractive Surgery, Sadalla Amin Ghanem Eye Hospital, Joinville, SC 89201, BrazilDepartment of Cornea and Refractive Surgery, Sadalla Amin Ghanem Eye Hospital, Joinville, SC 89201, BrazilDepartment of Ophthalmology, University of São Paulo, São Paulo, SP 05403-000, BrazilDepartment of Ophthalmology, University of São Paulo, São Paulo, SP 05403-000, BrazilPurpose. To report two unusual cases of idiopathic lipid keratopathy with symmetrical bilateral annular corneal lipid infiltration and describe confocal microscopy findings. Methods. Case reports. Results. We report two patients with bilateral peripheral deep stromal lipid deposits beginning in an arcuate pattern and progressing to a complete annular shape. Cholesterol crystals were observed in the paracentral area in both cases with characteristic crystalline-like structures in the confocal microscopy. Deep thin corneal blood vessels were observed in one patient, but no cause for then was established, despite decades of followup. This patient had an idiopathic limbitis as well, occurring in episodes. No previous ocular trauma, systemic disease or family history was reported for both cases. Conclusion. These two cases of idiopathic annular lipid keratopathy were observed for more than a decade with documented slow and insidious progression of the infiltrates, in spite of the use of topical steroids in one case. In the majority of other reported cases, a penetrating keratoplasty was made necessary. Differently, we showed that the visual acuity can remain quite good for years with very slow deterioration.http://dx.doi.org/10.1155/2012/731413
spellingShingle Ramon C. Ghanem
Vinícius C. Ghanem
Gustavo Victor
Milton Ruiz Alves
Bilateral Progressive Idiopathic Annular Lipid Keratopathy
Case Reports in Ophthalmological Medicine
title Bilateral Progressive Idiopathic Annular Lipid Keratopathy
title_full Bilateral Progressive Idiopathic Annular Lipid Keratopathy
title_fullStr Bilateral Progressive Idiopathic Annular Lipid Keratopathy
title_full_unstemmed Bilateral Progressive Idiopathic Annular Lipid Keratopathy
title_short Bilateral Progressive Idiopathic Annular Lipid Keratopathy
title_sort bilateral progressive idiopathic annular lipid keratopathy
url http://dx.doi.org/10.1155/2012/731413
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