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Corneal stromal calcification after topical steroid-phosphate therapy
U Schlötzer-Schrehardt1, Z Zagórski, L M Holbach
1Department of Ophthalmology, University Erlangen-Nürnberg, Germany. ursula.schloetzer@augen.med.uni-erlangen.de
Archives of Ophthalmology (Chicago, Ill. : 1960)
|October 26, 1999
Summary
Topical steroid-phosphate therapy can cause rare secondary corneal calcification, affecting the full corneal stroma. This study details an unusual case, highlighting potential glycosaminoglycan metabolism changes in stromal keratocytes.
Area of Science:
- Ophthalmology
- Corneal Diseases
- Ocular Pharmacology
Background:
- Secondary corneal calcification is a rare complication associated with severe dry eye, corneal ulcers, chronic inflammation, or multiple surgeries.
- Topical steroid-phosphate therapy is a common treatment for various ocular inflammatory conditions.
Observation:
- This report details an unusual case of calcareous degeneration of the corneal stroma in a patient undergoing topical steroid-phosphate therapy for chronic keratoconjunctivitis.
- The patient presented with normal serum calcium and phosphorus levels, ruling out systemic metabolic disorders.
Findings:
- Histopathology and electron microscopy revealed intracellular crystalline calcium phosphate deposits throughout the corneal stroma, sparing the Bowman layer.
- Energy-dispersive x-ray analysis confirmed the presence of calcium phosphate deposits.
- These deposits were associated with intracellular and pericellular glycosaminoglycan accumulation.
Implications:
- Topical steroid-phosphate medications may induce corneal stromal calcification.
- Alterations in glycosaminoglycan metabolism within corneal stromal keratocytes could play a role in this calcification process.
- This finding expands the understanding of iatrogenic corneal complications and their underlying mechanisms.