Ophthalmology in China

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A special local sclera degeneration in old people

DONG Zhe,  LI Bin, SONG Xu-dong,   YANG Wen-li,  XU Xiao-lin,  XIN Chen, LIU Han-ruo,  WANG Ning-li   

  1. Beijing Tongren Eye Center,  Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology and Visual Science,  Beijing Tongren Hospital,  Capital Medical University,  Beijing 100730,  China
  • Received:2018-01-08 Online:2018-03-25 Published:2018-03-24
  • Contact: WANG Ning-li, Email: Wningli@vip.163.com

Abstract:

Objective To report a special local sclera degeneration located posterior to corneal limbus in old people. Design Retrospective case series. Participants 32 cases (51 eyes) of out-patients with cataract whose sclera showed local abnormal appearance from May 2016 to Dec 2017. Methods We reviewed the measurement of the eyes with slit-lamp,  anterior segment optical coherence tomography (OCT),  ultrasound biomicroscopy (UBM),and B scan. We also had the opportunity to perform pathological examination in one case. Main Outcome Measures The location,  the morphology,  the size of the lesion,  and the pathological findings. Results The age of these patients ranged from 61~86 years (mean 71.12±11.43 years). Among them,  10 cases were male (31.25%),  and 22 cases were female (68.75%). In all 51 eyes the lesion located in the nasal side posterior to corneal limbus of the fissurae palpebrae,  which appeared cinerous,  sharply-defined,  oval shape of about 2 mm ×5 mm,  with micro cyst appearance under slit-lamp microscopy. The abnormal area showed low echo and low reflection on OCT and UBM. The distance from the upper edge of the low echo area to the outer surface of sclera was 0.11~0.29 mm,  and the distance from the lower edge of the low echo area to the inner surface of sclera was 0.31~0.48 mm. No sclera stampyloma was detected with B scan. Histopathological examination showed that the lesion was a  blue-purple amorphous degenerative change. Conclusion We primarily reported a special local sclera degeneration located posterior to corneal limbus in old people. This kind of pathological change occurred in the nasal side of the fissurae palpebrae,  and appeared cinerous,  sharply defined,  oval shape. But its pathogenesis,  the relative factors,  and the clinical significance need to be further researched.(Ophthalmol CHN,  2018, 27:95-98)

Key words: scleral, degeneration, the aged