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Norihisa Takahashi - One of the best experts on this subject based on the ideXlab platform.
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safety and efficacy of benzalkonium chloride optimized tafluprost in japanese glaucoma patients with existing superficial Punctate Keratitis
Journal of Glaucoma, 2015Co-Authors: Katsuyoshi Suzuki, Shinichiro Teranishi, Takeshi Sagara, Hideaki Yoshino, Masako Nakayama, Miho Enoki, Yoshihisa Nuno, Shinji Hirano, Makiko Wakuta, Norihisa TakahashiAbstract:PURPOSE To evaluate the safety and efficacy of benzalkonium chloride (BAK)-optimized tafluprost (with a BAK concentration reduced from 0.01% to 0.001%) in glaucoma patients with existing superficial Punctate Keratitis (SPK). PATIENTS AND METHODS A prospective, multicenter, open-label study was designed to compare BAK-optimized tafluprost administered over 12 weeks relative to other preserved prostaglandin analogs previously administered in Japanese glaucoma patients. Thirty patients with SPK graded at <6 points by area density (AD) scoring in 1 eye were recruited. The primary outcome measure was change in AD score at 12 weeks after the switch in treatment compared with that at baseline. Secondary outcome measures included changes in tear film breakup time (TBUT), hyperemia score, and intraocular pressure (IOP). Four patients were excluded from analysis because of treatment discontinuation. RESULTS Mean AD score±SD decreased significantly from 3.4±0.9 to 1.8±1.8 after the switch (P<0.0001). Mean TBUT increased significantly from 6.3±3.3 to 8.0±4.2 seconds (P<0.01). Mean hyperemia score remained unchanged, whereas mean IOP decreased significantly from 15.6±2.6 to 14.4±2.0 mm Hg (P<0.01). For patients previously treated with BAK-preserved latanoprost (n=17) or bimatoprost (n=2), mean AD score decreased significantly from 3.4±0.9 to 1.8±1.8 (P<0.01) and mean TBUT increased significantly from 6.4±3.6 to 8.2±4.3 seconds (P<0.01); no such changes were apparent for patients previously treated with sofZia-preserved travoprost (n=7). CONCLUSIONS BAK-optimized tafluprost is a treatment option to improve the condition of the ocular surface and to maintain IOP control in glaucoma patients with existing SPK who have been previously treated with other BAK-preserved prostaglandin analogs.
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Safety and Efficacy of Benzalkonium Chloride-optimized Tafluprost in Japanese Glaucoma Patients With Existing Superficial Punctate Keratitis
Journal of glaucoma, 2015Co-Authors: Katsuyoshi Suzuki, Shinichiro Teranishi, Takeshi Sagara, Hideaki Yoshino, Masako Nakayama, Miho Enoki, Yoshihisa Nuno, Shinji Hirano, Makiko Wakuta, Norihisa TakahashiAbstract:PURPOSE To evaluate the safety and efficacy of benzalkonium chloride (BAK)-optimized tafluprost (with a BAK concentration reduced from 0.01% to 0.001%) in glaucoma patients with existing superficial Punctate Keratitis (SPK). PATIENTS AND METHODS A prospective, multicenter, open-label study was designed to compare BAK-optimized tafluprost administered over 12 weeks relative to other preserved prostaglandin analogs previously administered in Japanese glaucoma patients. Thirty patients with SPK graded at
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© 2009 Molecular Vision In vivo observation of Langerhans cells by laser confocal microscopy in Thygeson’s superficial Punctate Keratitis
2013Co-Authors: Koji Kawamoto, Norihisa Takahashi, Tai-ichiro Chikama, Teruo NishidaAbstract:Purpose: To characterize the cornea of individuals with Thygeson’s superficial Punctate Keratitis (TSPK) at the cellular level by laser confocal biomicroscopy. Methods: Both corneas of three patients with TSPK referred to Yamaguchi University Hospital were imaged with a laser confocal biomicroscope. Morphological changes were evaluated for each layer of the cornea. Results: The number of Langerhans cells was greatly increased in the basal cell layer of the focal corneal epithelium and in Bowman’s layer in the four eyes affected by TSPK. Aggregates of these cells were associated with the subepithelial nerve plexus. Langerhans cells were also evident in the unaffected eyes of the two patients with unilateral TSPK, although their numbers were much smaller than those in the affected eyes. Topical treatment with betamethasone phosphate resulted in the virtual disappearance of Langerhans cells from the affected eyes. Conclusion: The prominent association of Langerhans cells with TSPK suggests that the activation of these cells by inflammatory conditions might contribute to the pathogenesis of this disorder. Thygeson’s superficial Punctate Keratitis (TSPK) is characterized clinically by ocular irritation, tearing, photophobia, and visual disturbance but has minimal clinical manifestations in the cornea [1-3]. It usually develop
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In vivo observation of Langerhans cells by laser confocal microscopy in Thygeson’s superficial Punctate Keratitis
Molecular vision, 2009Co-Authors: Koji Kawamoto, Norihisa Takahashi, Tai-ichiro Chikama, Teruo NishidaAbstract:Purpose: To characterize the cornea of individuals with Thygeson’s superficial Punctate Keratitis (TSPK) at the cellular level by laser confocal biomicroscopy. Methods: Both corneas of three patients with TSPK referred to Yamaguchi University Hospital were imaged with a laser confocal biomicroscope. Morphological changes were evaluated for each layer of the cornea. Results: The number of Langerhans cells was greatly increased in the basal cell layer of the focal corneal epithelium and in Bowman’s layer in the four eyes affected by TSPK. Aggregates of these cells were associated with the subepithelial nerve plexus. Langerhans cells were also evident in the unaffected eyes of the two patients with unilateral TSPK, although their numbers were much smaller than those in the affected eyes. Topical treatment with betamethasone phosphate resulted in the virtual disappearance of Langerhans cells from the affected eyes. Conclusion: The prominent association of Langerhans cells with TSPK suggests that the activation of these cells by inflammatory conditions might contribute to the pathogenesis of this disorder. Thygeson’s superficial Punctate Keratitis (TSPK) is characterized clinically by ocular irritation, tearing, photophobia, and visual disturbance but has minimal clinical manifestations in the cornea [1-3]. It usually develops bilaterally, and slitlamp microscopic examination reveals aggregates of Punctate fluorescein staining in the corneal epithelium that correspond to elevated and coarse granular opacities [2]. Although the etiology of TSPK remains unclear, viral infection, allergic reactions, and immune responses to viral infection have been proposed to play a pathogenesis role. Lubricant eyedrops, eyedrops containing a low dose of corticosteroid, and soft contact lenses are options for medical management. In vivo imaging of eyes affected by TSPK has been performed by confocal microscopy [4]. The images revealed highly refractive microdots and refractive bodies immediately below the corneal epithelium, in Bowman’s layer, and in the anterior stroma. Morphological changes of keratocytes were also apparent in the previous reports. The Heidelberg Retinal Tomograph II, Rostock Cornea Module (HRTII-RCM; Heidelberg Engineering, Heidelberg, Germany) has recently been introduced into clinical practice in ophthalmology [5-9]. Given that its light source is a laser, the HRTII-RCM has provided images of individual cells of the cornea with high resolution. It has thus revealed the presence of Langerhans cells (LCs), a type of antigenpresenting cell, in the cornea. These cells are located in the
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in vivo observation of langerhans cells by laser confocal microscopy in thygeson s superficial Punctate Keratitis
Molecular Vision, 2009Co-Authors: Koji Kawamoto, Norihisa Takahashi, Tai-ichiro Chikama, Teruo NishidaAbstract:Purpose: To characterize the cornea of individuals with Thygeson’s superficial Punctate Keratitis (TSPK) at the cellular level by laser confocal biomicroscopy. Methods: Both corneas of three patients with TSPK referred to Yamaguchi University Hospital were imaged with a laser confocal biomicroscope. Morphological changes were evaluated for each layer of the cornea. Results: The number of Langerhans cells was greatly increased in the basal cell layer of the focal corneal epithelium and in Bowman’s layer in the four eyes affected by TSPK. Aggregates of these cells were associated with the subepithelial nerve plexus. Langerhans cells were also evident in the unaffected eyes of the two patients with unilateral TSPK, although their numbers were much smaller than those in the affected eyes. Topical treatment with betamethasone phosphate resulted in the virtual disappearance of Langerhans cells from the affected eyes. Conclusion: The prominent association of Langerhans cells with TSPK suggests that the activation of these cells by inflammatory conditions might contribute to the pathogenesis of this disorder. Thygeson’s superficial Punctate Keratitis (TSPK) is characterized clinically by ocular irritation, tearing, photophobia, and visual disturbance but has minimal clinical manifestations in the cornea [1-3]. It usually develops bilaterally, and slitlamp microscopic examination reveals aggregates of Punctate fluorescein staining in the corneal epithelium that correspond to elevated and coarse granular opacities [2]. Although the etiology of TSPK remains unclear, viral infection, allergic reactions, and immune responses to viral infection have been proposed to play a pathogenesis role. Lubricant eyedrops, eyedrops containing a low dose of corticosteroid, and soft contact lenses are options for medical management. In vivo imaging of eyes affected by TSPK has been performed by confocal microscopy [4]. The images revealed highly refractive microdots and refractive bodies immediately below the corneal epithelium, in Bowman’s layer, and in the anterior stroma. Morphological changes of keratocytes were also apparent in the previous reports. The Heidelberg Retinal Tomograph II, Rostock Cornea Module (HRTII-RCM; Heidelberg Engineering, Heidelberg, Germany) has recently been introduced into clinical practice in ophthalmology [5-9]. Given that its light source is a laser, the HRTII-RCM has provided images of individual cells of the cornea with high resolution. It has thus revealed the presence of Langerhans cells (LCs), a type of antigenpresenting cell, in the cornea. These cells are located in the
Helena M. Tabery - One of the best experts on this subject based on the ideXlab platform.
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Adenovirus Epithelial Keratitis and Thygeson's Superficial Punctate Keratitis - Adenovirus epithelial Keratitis and Thygeson's superficial Punctate Keratitis
2012Co-Authors: Helena M. TaberyAbstract:Adenovirus epithelial Keratitis and Thygeson's superficial Punctate Keratitis , Adenovirus epithelial Keratitis and Thygeson's superficial Punctate Keratitis , کتابخانه مرکزی دانشگاه علوم پزشکی تهران
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adenovirus epithelial Keratitis and thygeson s superficial Punctate Keratitis
2012Co-Authors: Helena M. TaberyAbstract:Adenovirus epithelial Keratitis and Thygeson's superficial Punctate Keratitis , Adenovirus epithelial Keratitis and Thygeson's superficial Punctate Keratitis , کتابخانه مرکزی دانشگاه علوم پزشکی تهران
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the morphology of thygeson s superficial Punctate Keratitis tspk
2012Co-Authors: Helena M. TaberyAbstract:The smallest discernible entity is a rounded, light-reflecting subsurface cell (about 10–15 μm in diameter). Such cells are present individually, in small groups, or aggregated in larger lesions (of about 150–400 μm in diameter, coarse lesions with the slit lamp). The nature of these cells, so clearly abnormal to the corneal epithelium, is not clear; they may represent damaged epithelial cells, invading inflammatory cells, or both. In some of the larger lesions small groups of aggregated rounded/abnormal cells are discernible, in others they just seem heaped-up and/or mixed with cell debris. The lesions’ shapes vary between rounded and somewhat irregular. All show rounded/abnormal cells at the edges, which thus appear rugged. The rounded/abnormal cells, whether individual or aggregated, are superficially located, but their exact location in depth cannot be estimated in two-dimensional images. The absence of changes indicating stromal involvement suggests an intraepithelial location. Subepithelial opacities, if developing, appeared in the present patients as a mild, transient subepithelial haze lacking abnormal cells; no informative photographs could be obtained from them.
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three atypical cases of thygeson s superficial Punctate Keratitis tspk
2012Co-Authors: Helena M. TaberyAbstract:With the slit lamp, the hallmark of TSPK are coarse granular epithelial lesions spread over the surface. The “atypical” cases are occasional patients in whom this description does not fit; yet, seen at higher magnification, the basic feature – the presence of rounded/abnormal cells within the epithelium – is the same, and so is the accompanying (unspecific) phenomenon of cysts containing one or a few rounded cells. The same history, symptoms, and the extreme cortisone sensitivity added, these patients seem to represent a variant of the same disease in which, for some reasons, the distribution pattern of the rounded/abnormal cells is more diffuse instead of the well-known distinct lesions, and the cyst are more abundant. Because of the at random confluence resulting in patterns reminding of branching (dendritic) figures, these rare cases tend to be confused with HSV rather than with adenovirus infections.
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The Morphology of Thygeson’s Superficial Punctate Keratitis (TSPK)
Adenovirus Epithelial Keratitis and Thygeson's Superficial Punctate Keratitis, 2011Co-Authors: Helena M. TaberyAbstract:The smallest discernible entity is a rounded, light-reflecting subsurface cell (about 10–15 μm in diameter). Such cells are present individually, in small groups, or aggregated in larger lesions (of about 150–400 μm in diameter, coarse lesions with the slit lamp). The nature of these cells, so clearly abnormal to the corneal epithelium, is not clear; they may represent damaged epithelial cells, invading inflammatory cells, or both. In some of the larger lesions small groups of aggregated rounded/abnormal cells are discernible, in others they just seem heaped-up and/or mixed with cell debris. The lesions’ shapes vary between rounded and somewhat irregular. All show rounded/abnormal cells at the edges, which thus appear rugged. The rounded/abnormal cells, whether individual or aggregated, are superficially located, but their exact location in depth cannot be estimated in two-dimensional images. The absence of changes indicating stromal involvement suggests an intraepithelial location. Subepithelial opacities, if developing, appeared in the present patients as a mild, transient subepithelial haze lacking abnormal cells; no informative photographs could be obtained from them.
Teruo Nishida - One of the best experts on this subject based on the ideXlab platform.
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© 2009 Molecular Vision In vivo observation of Langerhans cells by laser confocal microscopy in Thygeson’s superficial Punctate Keratitis
2013Co-Authors: Koji Kawamoto, Norihisa Takahashi, Tai-ichiro Chikama, Teruo NishidaAbstract:Purpose: To characterize the cornea of individuals with Thygeson’s superficial Punctate Keratitis (TSPK) at the cellular level by laser confocal biomicroscopy. Methods: Both corneas of three patients with TSPK referred to Yamaguchi University Hospital were imaged with a laser confocal biomicroscope. Morphological changes were evaluated for each layer of the cornea. Results: The number of Langerhans cells was greatly increased in the basal cell layer of the focal corneal epithelium and in Bowman’s layer in the four eyes affected by TSPK. Aggregates of these cells were associated with the subepithelial nerve plexus. Langerhans cells were also evident in the unaffected eyes of the two patients with unilateral TSPK, although their numbers were much smaller than those in the affected eyes. Topical treatment with betamethasone phosphate resulted in the virtual disappearance of Langerhans cells from the affected eyes. Conclusion: The prominent association of Langerhans cells with TSPK suggests that the activation of these cells by inflammatory conditions might contribute to the pathogenesis of this disorder. Thygeson’s superficial Punctate Keratitis (TSPK) is characterized clinically by ocular irritation, tearing, photophobia, and visual disturbance but has minimal clinical manifestations in the cornea [1-3]. It usually develop
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In vivo observation of Langerhans cells by laser confocal microscopy in Thygeson’s superficial Punctate Keratitis
Molecular vision, 2009Co-Authors: Koji Kawamoto, Norihisa Takahashi, Tai-ichiro Chikama, Teruo NishidaAbstract:Purpose: To characterize the cornea of individuals with Thygeson’s superficial Punctate Keratitis (TSPK) at the cellular level by laser confocal biomicroscopy. Methods: Both corneas of three patients with TSPK referred to Yamaguchi University Hospital were imaged with a laser confocal biomicroscope. Morphological changes were evaluated for each layer of the cornea. Results: The number of Langerhans cells was greatly increased in the basal cell layer of the focal corneal epithelium and in Bowman’s layer in the four eyes affected by TSPK. Aggregates of these cells were associated with the subepithelial nerve plexus. Langerhans cells were also evident in the unaffected eyes of the two patients with unilateral TSPK, although their numbers were much smaller than those in the affected eyes. Topical treatment with betamethasone phosphate resulted in the virtual disappearance of Langerhans cells from the affected eyes. Conclusion: The prominent association of Langerhans cells with TSPK suggests that the activation of these cells by inflammatory conditions might contribute to the pathogenesis of this disorder. Thygeson’s superficial Punctate Keratitis (TSPK) is characterized clinically by ocular irritation, tearing, photophobia, and visual disturbance but has minimal clinical manifestations in the cornea [1-3]. It usually develops bilaterally, and slitlamp microscopic examination reveals aggregates of Punctate fluorescein staining in the corneal epithelium that correspond to elevated and coarse granular opacities [2]. Although the etiology of TSPK remains unclear, viral infection, allergic reactions, and immune responses to viral infection have been proposed to play a pathogenesis role. Lubricant eyedrops, eyedrops containing a low dose of corticosteroid, and soft contact lenses are options for medical management. In vivo imaging of eyes affected by TSPK has been performed by confocal microscopy [4]. The images revealed highly refractive microdots and refractive bodies immediately below the corneal epithelium, in Bowman’s layer, and in the anterior stroma. Morphological changes of keratocytes were also apparent in the previous reports. The Heidelberg Retinal Tomograph II, Rostock Cornea Module (HRTII-RCM; Heidelberg Engineering, Heidelberg, Germany) has recently been introduced into clinical practice in ophthalmology [5-9]. Given that its light source is a laser, the HRTII-RCM has provided images of individual cells of the cornea with high resolution. It has thus revealed the presence of Langerhans cells (LCs), a type of antigenpresenting cell, in the cornea. These cells are located in the
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in vivo observation of langerhans cells by laser confocal microscopy in thygeson s superficial Punctate Keratitis
Molecular Vision, 2009Co-Authors: Koji Kawamoto, Norihisa Takahashi, Tai-ichiro Chikama, Teruo NishidaAbstract:Purpose: To characterize the cornea of individuals with Thygeson’s superficial Punctate Keratitis (TSPK) at the cellular level by laser confocal biomicroscopy. Methods: Both corneas of three patients with TSPK referred to Yamaguchi University Hospital were imaged with a laser confocal biomicroscope. Morphological changes were evaluated for each layer of the cornea. Results: The number of Langerhans cells was greatly increased in the basal cell layer of the focal corneal epithelium and in Bowman’s layer in the four eyes affected by TSPK. Aggregates of these cells were associated with the subepithelial nerve plexus. Langerhans cells were also evident in the unaffected eyes of the two patients with unilateral TSPK, although their numbers were much smaller than those in the affected eyes. Topical treatment with betamethasone phosphate resulted in the virtual disappearance of Langerhans cells from the affected eyes. Conclusion: The prominent association of Langerhans cells with TSPK suggests that the activation of these cells by inflammatory conditions might contribute to the pathogenesis of this disorder. Thygeson’s superficial Punctate Keratitis (TSPK) is characterized clinically by ocular irritation, tearing, photophobia, and visual disturbance but has minimal clinical manifestations in the cornea [1-3]. It usually develops bilaterally, and slitlamp microscopic examination reveals aggregates of Punctate fluorescein staining in the corneal epithelium that correspond to elevated and coarse granular opacities [2]. Although the etiology of TSPK remains unclear, viral infection, allergic reactions, and immune responses to viral infection have been proposed to play a pathogenesis role. Lubricant eyedrops, eyedrops containing a low dose of corticosteroid, and soft contact lenses are options for medical management. In vivo imaging of eyes affected by TSPK has been performed by confocal microscopy [4]. The images revealed highly refractive microdots and refractive bodies immediately below the corneal epithelium, in Bowman’s layer, and in the anterior stroma. Morphological changes of keratocytes were also apparent in the previous reports. The Heidelberg Retinal Tomograph II, Rostock Cornea Module (HRTII-RCM; Heidelberg Engineering, Heidelberg, Germany) has recently been introduced into clinical practice in ophthalmology [5-9]. Given that its light source is a laser, the HRTII-RCM has provided images of individual cells of the cornea with high resolution. It has thus revealed the presence of Langerhans cells (LCs), a type of antigenpresenting cell, in the cornea. These cells are located in the
Khalid F. Tabbara - One of the best experts on this subject based on the ideXlab platform.
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Topical Tacrolimus in Thygeson Superficial Punctate Keratitis.
Cornea, 2020Co-Authors: Samir S. Shoughy, Khalid F. TabbaraAbstract:PURPOSE To evaluate the efficacy of topical tacrolimus 0.02% eye drops in the treatment of patients with Thygeson superficial Punctate Keratitis. METHODS Ten consecutive patients with Thygeson superficial Punctate Keratitis were included retrospectively. Seven patients were unresponsive to topical steroids and/or lubricants. Diagnosis was made based on the history and clinical findings. All patients were treated with topical tacrolimus 0.02% solution twice daily. Outcome measures included improvement in symptoms of tearing and photophobia, whereas improvement in signs included decrease in the number of the lesions, resolution of the lesions, flattening of the lesions, and decrease in stain of the lesions. RESULTS There were 3 male and 7 female patients with an age range of 3 to 51 years (mean 17 years). All patients had bilateral ocular involvement. Duration of treatment ranged from 1 to 42 weeks (mean 10 weeks). All patients had subjective improvement in symptoms of tearing and photophobia and resolution of the superficial Punctate Keratitis. The response to treatment was noted 72 hours after initiation of therapy in all patients. Topical tacrolimus was well tolerated in all patients. CONCLUSIONS Topical tacrolimus 0.02% is safe and effective in reducing ocular surface inflammation in patients with Thygeson superficial Punctate Keratitis who are not responsive to conventional therapy. Tacrolimus is helpful as a steroid-sparing agent to avoid vision-threatening complications.
Kazuhisa Sugiyama - One of the best experts on this subject based on the ideXlab platform.
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In vivo laser confocal microscopy findings of Thygeson superficial Punctate Keratitis.
Cornea, 2011Co-Authors: Akira Kobayashi, Hideaki Yokogawa, Kazuhisa SugiyamaAbstract:Purpose We looked for microstructural corneal characteristics of Thygeson superficial Punctate Keratitis (TSPK) in an in vivo investigation using laser scanning confocal microscopy. Methods Five patients (3 men and 2 women; mean age, 51.8 years) with clinically diagnosed TSPK were enrolled in this study. All patients were examined by slit-lamp biomicroscopy and in vivo laser confocal microscopy. Deposits in selected confocal images of all corneal layers were evaluated qualitatively for shape and degree of light reflection. Results The most characteristic finding was aggregates of highly reflective deposits with a starburst-like appearance that corresponded with epithelial Punctate lesions identified by slit-lamp biomicroscopy; the aggregates were sporadically observed in all cases at the superficial and basal epithelial cell layers. Subepithelial haze was observed in all cases. Langerhans cells were also sporadically observed in all cases at the basal epithelial layer. Bowman layer abnormalities were observed in 3 of 5 cases; all these patients had a long history of TSPK (eg, more than 1 year). In addition, the 3 patients had highly reflective, tiny, needle-shaped materials in the corneal stroma. Conclusions In vivo laser confocal microscopy is capable of identifying characteristic corneal microstructural changes related to TSPK with a higher resolution than is available with slit-lamp biomicroscopy. It may also be a valuable tool for further research to elucidate both pathogenesis and the natural course of TSPK.
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Disappearance of honeycomb opacity of Thiel-Behnke corneal dystrophy after Thygeson superficial Punctate Keratitis.
Cornea, 2005Co-Authors: Akira Kobayashi, Shigeyuki Ijiri, Taeko Ohta, Kazuhisa SugiyamaAbstract:PURPOSE To present an unusual case in which the honeycomb opacities of Thiel-Behnke corneal dystrophy disappeared during a course of chronic Thygeson superficial Punctate Keratitis. CASE A 29-year-old woman with a 5-year history of decreased visual acuity in both eyes had bilateral honeycomb-shaped corneal opacities, located mainly in the superficial central cornea. She was diagnosed as having Thiel-Behnke corneal dystrophy, which we confirmed genetically. During follow-up, her left eye was affected by chronic Thygeson superficial Punctate Keratitis, and the honeycomb opacity in this eye was noted to have disappeared. CONCLUSIONS We observed the dissolution of honeycomb-like corneal opacities in a patient with confirmed Thiel-Behnke corneal dystrophy after the patient subsequently contracted chronic Thygeson superficial Punctate Keratitis. We surmise that epithelial inflammation associated with Thygeson epithelial Keratitis may play a role in dissolving the honeycomb opacities.
