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Terrien Marginal Degeneration: Clinical Characteristics and Outcomes.

Aaron T Chan1, Randall Ulate2, Yakov Goldich2

  • 1University of Toronto Medical School, Toronto, Canada.

American Journal of Ophthalmology
|July 27, 2015
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Summary
This summary is machine-generated.

Terrien marginal degeneration is a slowly progressive peripheral corneal disease, typically affecting men over 40 and causing significant astigmatism. While rare, perforations can lead to vision loss, necessitating surgical intervention in some cases.

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Area of Science:

  • Ophthalmology
  • Corneal Diseases
  • Ophthalmic Surgery

Background:

  • Terrien marginal degeneration (TMD) is a rare, bilateral, and asymmetric peripheral corneal degeneration.
  • It commonly affects men over 40, presenting with stromal thinning, vascularization, lipid deposition, and against-the-rule astigmatism.

Purpose of the Study:

  • To describe the clinical outcomes and management of patients diagnosed with Terrien marginal degeneration.
  • To analyze demographic data, disease progression, visual acuity, and surgical interventions in TMD patients.

Main Methods:

  • A retrospective case series was conducted.
  • Data from 25 patients (43 eyes) diagnosed with TMD between 2004 and 2013 were reviewed.
  • Outcome measures included demographics, disease location, topographic astigmatism, visual acuity, ocular comorbidities, and surgical management.

Main Results:

  • The mean age at presentation was 44 years, with 54% of patients being male. 72% had bilateral disease.
  • Mean topographic astigmatism was 4.02 diopters, progressing over time. Mean best spectacle-corrected visual acuity (BSCVA) was 20/46 at presentation and 20/48 at follow-up.
  • 23.3% of eyes required surgery, with a mean BSCVA of 20/81 preoperatively and 20/106 postoperatively. Five eyes perforated, and 56% presented with ocular surface inflammation.

Conclusions:

  • Terrien marginal degeneration is a slowly progressive peripheral corneal degeneration, often associated with significant astigmatism and affecting older men.
  • While typically non-inflammatory, a variant with prominent inflammation exists. Surgical intervention, such as lamellar grafting, can be crucial for preserving corneal integrity and vision.
  • Perforations, though rare, are a serious complication that can result in substantial vision loss, highlighting the importance of timely management.