Circumferential nodulocystic keratopathy. A case report

An apparently unique type of corneal nodular keratopathy is presented. The keratopathy was characterized by large, circumferentially bilaterally located, cystic nodules just inside the limbus. No epithelial cell or collagenous degeneration nor evidence of chronic inflammatory process was found on histopathologic examination of a biopsy of a nodule. Proteinaceous material was present between the epithelial cell basement membrane and collagenous stroma. There was no antecedent history of keratitis or uveitis. The patient was known to have inflammatory bowel disease (regional ileitis) and rheumatoid arthritis with ankylosing spondylitis. However, the corneal lesions could not definitely be associated with any of these disorders. This case does not correspond with any previously described corneal disorders. We have termed it circumferential nodulocystic keratopathy, which best describes its clinical and histologic features.