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Nontraumatic Descemet Membrane Detachment with Tear in Osteogenesis Imperfecta.

Polat N, Ulucan PB - Ophthalmol Ther (2015)

Bottom Line: It was thought that monitoring the patient without intervention and only considering a surgical procedure if the disorder progressed was the best option, taking into account the patient's reasonable visual acuity and the risks of keratoplasty.The dimensions of the DMD and tear had remained the same at 1-year follow-up period.We believe that follow-up without intervention should be considered for non-progressive DMD with a giant tear if the patient has a single functional eye.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Medical Faculty, Inonu University, 44 280, Malatya, Turkey, drnihatpolat@gmail.com.

ABSTRACT
We report the first case of unilateral spontaneous Descemet membrane detachment (DMD) with tear occurring in a patient with osteogenesis imperfecta (OI). A 20-year-old male patient with OI presented with a history of recent primary repair (2 weeks prior) of left globe rupture following local finger trauma to the left eye. The patient had no history of other ocular surgery or trauma. The examination revealed a best corrected visual acuity of 20/40 in the right and no light perception in the left eye. Slit-lamp examination showed an oval giant Descemet tear extending from the 12 o'clock to the 5 o'clock area and a large DMD involving the upper and nasal quadrants in the right cornea. It was thought that monitoring the patient without intervention and only considering a surgical procedure if the disorder progressed was the best option, taking into account the patient's reasonable visual acuity and the risks of keratoplasty. The dimensions of the DMD and tear had remained the same at 1-year follow-up period. We believe that follow-up without intervention should be considered for non-progressive DMD with a giant tear if the patient has a single functional eye.

No MeSH data available.


Related in: MedlinePlus

The image of the right showing Descemet tear
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Fig1: The image of the right showing Descemet tear

Mentions: A 20-year-old male patient with OI presented with a history of recent primary repair of left globe rupture (2 weeks prior) following local finger trauma to the left eye. The patient had no history of other ocular surgery. The examination revealed a best corrected visual acuity (BCVA) of 20/40 in the right eye and no light perception in the left eye. Slit-lamp examination showed an oval giant Descemet tear extending from the 12 o’clock to the 5 o’clock area and a large DMD involving the upper and nasal quadrants in the right cornea (Fig. 1). The patient had no other ocular clinical features of OI. The DMD was observed to be stretched (Fig. 2). There was no corneal edema, but interestingly there was peripheral superficial corneal vascularization in the areas where the Descemet membrane was attached. There was no history of contact lens use. The iris, lens and fundus were normal. The intraocular pressure was 20 mmHg when measured with a Goldmann applanation tonometer. The left eye had no light perception during the postoperative period. The anterior chamber structures could not be discerned on the slit lamp due to hyphema but the perforated areas had been sutured. The peripheral cornea of the left eye showed vascularization similar to the right eye. The conjunctiva was hyperemic and chemotic (Fig. 3).Fig. 1


Nontraumatic Descemet Membrane Detachment with Tear in Osteogenesis Imperfecta.

Polat N, Ulucan PB - Ophthalmol Ther (2015)

The image of the right showing Descemet tear
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4470985&req=5

Fig1: The image of the right showing Descemet tear
Mentions: A 20-year-old male patient with OI presented with a history of recent primary repair of left globe rupture (2 weeks prior) following local finger trauma to the left eye. The patient had no history of other ocular surgery. The examination revealed a best corrected visual acuity (BCVA) of 20/40 in the right eye and no light perception in the left eye. Slit-lamp examination showed an oval giant Descemet tear extending from the 12 o’clock to the 5 o’clock area and a large DMD involving the upper and nasal quadrants in the right cornea (Fig. 1). The patient had no other ocular clinical features of OI. The DMD was observed to be stretched (Fig. 2). There was no corneal edema, but interestingly there was peripheral superficial corneal vascularization in the areas where the Descemet membrane was attached. There was no history of contact lens use. The iris, lens and fundus were normal. The intraocular pressure was 20 mmHg when measured with a Goldmann applanation tonometer. The left eye had no light perception during the postoperative period. The anterior chamber structures could not be discerned on the slit lamp due to hyphema but the perforated areas had been sutured. The peripheral cornea of the left eye showed vascularization similar to the right eye. The conjunctiva was hyperemic and chemotic (Fig. 3).Fig. 1

Bottom Line: It was thought that monitoring the patient without intervention and only considering a surgical procedure if the disorder progressed was the best option, taking into account the patient's reasonable visual acuity and the risks of keratoplasty.The dimensions of the DMD and tear had remained the same at 1-year follow-up period.We believe that follow-up without intervention should be considered for non-progressive DMD with a giant tear if the patient has a single functional eye.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Medical Faculty, Inonu University, 44 280, Malatya, Turkey, drnihatpolat@gmail.com.

ABSTRACT
We report the first case of unilateral spontaneous Descemet membrane detachment (DMD) with tear occurring in a patient with osteogenesis imperfecta (OI). A 20-year-old male patient with OI presented with a history of recent primary repair (2 weeks prior) of left globe rupture following local finger trauma to the left eye. The patient had no history of other ocular surgery or trauma. The examination revealed a best corrected visual acuity of 20/40 in the right and no light perception in the left eye. Slit-lamp examination showed an oval giant Descemet tear extending from the 12 o'clock to the 5 o'clock area and a large DMD involving the upper and nasal quadrants in the right cornea. It was thought that monitoring the patient without intervention and only considering a surgical procedure if the disorder progressed was the best option, taking into account the patient's reasonable visual acuity and the risks of keratoplasty. The dimensions of the DMD and tear had remained the same at 1-year follow-up period. We believe that follow-up without intervention should be considered for non-progressive DMD with a giant tear if the patient has a single functional eye.

No MeSH data available.


Related in: MedlinePlus