Bilateral consecutive central corneal perforations associated with hypogammaglobulinemia

Esen Karamursel Akpek, Randa S. Haddad, Jerry A. Winkelstein, John D. Gottsch

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To describe the presentation and the clinical course of a patient with consecutive central sterile corneal perforations associated with common variable immunodeficiency. Design: Case report. Methods: Multiple corneal cultures and scrapings were performed in an effort to identify an infectious cause and all were negative. Corneal biopsy did not demonstrate any evidence of micro-organisms. An extended investigation failed to uncover a collagen vascular cause or atopy. Results: Progressive sterile stromal thinning with intact epithelium in the left eye proceeded to perforation despite topical treatment, and cyanoacrylate gluing was performed. However, a secondary Haemophilus influenza endophthalmitis developed, and the eye was eventually lost. The fellow eye proceeded along the same clinical course with sterile stromal thinning. A lamellar patch graft was performed when the central ulceration progressed to a descemetocele. The eye remained quiet with 20/25 vision for 2 years, until the patient died from complications of a liver transplant. Conclusions: Devastating central sterile corneal thinning leading to perforation may occur in patients with hypogammaglobulinemia, Clinical features and course suggest an autoimmune cause. (C) 2000 by the American Academy of Ophthalmology.

Original languageEnglish (US)
Pages (from-to)123-126
Number of pages4
JournalOphthalmology
Volume107
Issue number1
DOIs
StatePublished - Jan 2000

ASJC Scopus subject areas

  • Ophthalmology

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