Presumed autoimmune corneal endotheliopathy

Area of Science:

• Ophthalmology
• Immunology

Background:

• Recurrent corneal diseases can significantly impair vision.
• Understanding the underlying etiology is crucial for effective treatment.

Observation:

• Two male patients presented with unusual, bilateral, symmetric corneal disease.
• Characterized by peripheral stromal edema progressing centrally, linear keratic precipitates, and endothelial destruction.
• Absence of herpetic keratitis, trauma, or syphilis, with minimal anterior chamber reaction.

Findings:

• The pattern of linear endothelial destruction is similar to corneal allograft rejection.
• Aqueous humor analysis revealed macrophages and lymphocytes.
• Rapid improvement was observed following corticosteroid therapy.

Implications:

• The clinical presentation and response to treatment suggest an autoimmune etiology for this corneal disease.
• This finding may indicate a novel autoimmune condition affecting the cornea.
• Further research into autoimmune mechanisms in corneal pathology is warranted.