Clinical Report: In Vivo Morphological Features of Acquired Corneal Subepithelial Hypertrophy
Overview
This study characterizes the in vivo morphological features of Acquired Corneal Subepithelial Hypertrophy (ACSH) using anterior segment optical coherence tomography (AS-OCT) and histopathological evaluation. The findings highlight the condition's male predominance and the potential for misdiagnosis due to non-specific slit-lamp findings.
Background
Acquired Corneal Subepithelial Hypertrophy (ACSH) is a rare corneal opacity that can occur following ocular surgery or trauma, leading to significant visual impairment. Accurate diagnosis is crucial as misidentification can result in unnecessary surgical interventions. Understanding the morphological characteristics of ACSH is essential for developing effective management strategies.
Data Highlights
Characteristic
Percentage
Paracentral Patchy Opacification (PPO)
41.7%
Peripheral Sectorial Nodules (PSN)
41.7%
Central Diffuse Mass (CDM)
16.7%
Key Findings
ACSH primarily affects males and presents with blurred vision.
Three subtypes of ACSH were identified: PPO, PSN, and CDM.
AS-OCT revealed hyperreflective lamellar deposits between the epithelium and stroma.
The maximum thickness of fibrosis correlated strongly with corneal surface thickness (r = 0.96; p < 0.0001).
Histopathological analysis indicated abnormal tissue repair and disorganized extracellular matrix deposition as potential drivers of ACSH.
Clinical Implications
The use of AS-OCT can enhance the accurate diagnosis of ACSH, differentiating it from other corneal opacities. Clinicians should consider ACSH in patients presenting with corneal opacities post-surgery and may employ superficial keratectomy as an effective treatment option.
Conclusion
The study provides valuable insights into the morphological features and management of ACSH, emphasizing the importance of accurate diagnosis to prevent unnecessary surgical interventions.
