Biomechanical and tomographic findings in Brown-McLean syndrome.
Brown-McLean syndrome
Corneal biomechanics
Corneal edema
Corneal tomography
Journal
American journal of ophthalmology case reports
ISSN: 2451-9936
Titre abrégé: Am J Ophthalmol Case Rep
Pays: United States
ID NLM: 101679941
Informations de publication
Date de publication:
Dec 2024
Dec 2024
Historique:
received:
03
06
2024
revised:
18
07
2024
accepted:
26
07
2024
medline:
1
9
2024
pubmed:
1
9
2024
entrez:
30
8
2024
Statut:
epublish
Résumé
Brown-McLean syndrome (BMS) is a clinical condition characterized by peripheral corneal edema with central corneal transparency. This study aims to document the tomographic and biomechanical characteristics of 3 patients with typical BMS features using the Pentacam® AXL and CORVIS ST® (Oculus Optikgeräte GmbH, Wetzlar, Germany). Three cases of BMS are presented. Case 1 involves a 26-year-old male, Case 2 a 55-year-old male, and Case 3 a 74-year-old male. The patients in Cases 1 and 3 had bilateral BMS, while the patient in Case 2 had BMS in the right eye and aphakic bullous keratopathy in the left eye. All three patients were aphakic following cataract surgery. Notably, Cases 1 and 2 were first-degree relatives (son and father), both with bilateral microspherophakia and resultant bilateral aphakia from pediatric cataract surgery. Tomographic analysis revealed a consistent increase in corneal thickness from the center to the periphery in BMS eyes, marked by an abrupt rise in the corneal thickness spatial profile (CTSP) and percentage thickness increase (PTI) curves from the thinnest point towards the periphery. There was no loss of parallel isopachs, no displacement of the thinnest point of the cornea, and no evidence of focal posterior corneal surface depression, typical signs of generalized corneal edema. Biomechanically, BMS eyes exhibited relatively normal corneal stiffness, integrated radius, Ambrósio's relational thickness to the horizontal profile (ARTh), and maximum deformation amplitude ratio at 2mm from the corneal apex (DA ratio). However, the left eye of the patient in Case 2, which had aphakic bullous keratopathy, showed altered biomechanical parameters indicative of a softer cornea with loss of rigidity. This case series is the first to evaluate the biomechanical and tomographic features of eyes with BMS. Despite the abrupt rise in CTSP and PTI curves from the thinnest point towards the periphery, the relatively normal central corneal biomechanical indices in these BMS eyes are expected when edema is limited to the periphery. These indices become abnormal when there is progression to central corneal edema with bullous keratopathy.
Identifiants
pubmed: 39211352
doi: 10.1016/j.ajoc.2024.102136
pii: S2451-9936(24)00146-4
pmc: PMC11359765
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Pagination
102136Informations de copyright
© 2024 The Authors.
Déclaration de conflit d'intérêts
The authors have no conflict of interest.
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