METHODS: A 72-year-old woman complained of acute pain of the left eye. Primary pterygia were noted in both eyes on the initial examination 4 months ago. Slit-lamp microscopy revealed a nasal corneal epithelial defect, and the rolled elevated lesion in the corneal limbus of the left eye. She was diagnosed with a spontaneous avulsion of the corneal pterygium head. Then the avulsed pterygium head slowly recurred. The pterygium head of the fellow eye had a yellow-whitish elevated lesion beneath the epithelium with poor vascularity. AS-OCT revealed hyper-reflective foci beneath the epithelium corresponding to the yellow-whitish elevated lesion.
CONCLUSIONS: The present case revealed the spontaneous avulsion of the pterygium head leading to the corneal epithelial defects and ocular pain, while the pterygium head of the fellow eye showed subepithelial hyper-reflective foci suspicious of spheroidal degeneration on AS-OCT. In this case, the cause of spontaneous avulsion of the pterygium head might be potentially weak adhesion to the cornea due to spheroidal degeneration.
CONCLUSIONS: This case is a primary pterygium leading to spontaneous avulsion, in which hyper-reflective foci were noted in OCT.
方法:一名72岁女性主诉左眼急性疼痛。4个月前初次检查时,双眼均发现原发性翼状胬肉。裂隙灯显微镜显示鼻角膜上皮缺损,和左眼角膜缘卷曲的隆起病变。她被诊断为角膜翼状胬肉头部自发性撕脱。然后撕脱的翼状胬肉头部缓慢复发。另一只眼的翼状胬肉头部在上皮下方有黄白色的隆起性病变,血管分布不良。AS-OCT显示上皮下方的高反射灶,对应于黄白色的升高病变。
结论:本病例显示翼状胬肉头部自发性撕脱导致角膜上皮缺损和眼部疼痛,而对眼的翼状胬肉头部在AS-OCT上显示上皮下高反射灶,怀疑球样变性。在这种情况下,翼状胬肉头部自发撕脱的原因可能是球形变性导致的角膜粘连较弱。
结论:此病例是原发性翼状胬肉,导致自发性撕脱,在OCT中发现了高反射灶。