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Liwu G. Chen, Paul T. Finger; Idiopathic Multifocal Pigmented Plaques on the Corneal Endothelium. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6022.
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To report on the novel findings associated with idiopathic multifocal pigmented plaques on the corneal endothelium.
A retrospective chart review was performed to evaluate the demographic patterns, medical history, ophthalmic examinations, and high-frequency ultrasound images of two patients with asymptomatic idiopathic corneal endothelial plaques. Further, a PubMed literature search was performed using the key words: corneal, endothelial, and pigment. Then a review of textbooks was performed: Grayson’s Diseases of the Cornea, Rapuano’s Cornea: color atlas & synopsis of clinical ophthalmology, and Reinhard’s Essentials in Ophthalmology: Cornea and External Eye Disease.
Two female patients, 49 years old and 43 years old, both of African descent were referred by their primary ophthalmologist for evaluation of idiopathic pigmented plaques on their corneal endothelium. After thorough examination by an ocular oncologist, they were determined to be rare and unassociated with any synchronous intraocular pathology. Slit lamp biomicroscopy revealed no iris transillumination defects. Gonioscopy revealed distinct, well circumscribed brown pigmented plaques adherent to the dependent portions of the corneal endothelial surface with no extension to the ciliary body. High frequency ultrasound imaging revealed mild ciliary body thickening with anterior displacement of the ciliary processes in case one and unremarkable anatomy in case two. The lesions have remained unchanged for 34 and 12 months respectively. The literature search yielded no prior reports of this condition.
Multifocal pigmented corneal endothelial plaques were found in two African American women with otherwise normal eyes. To our knowledge no other cases have been documented in literature. These plaques were not associated with any ocular processes known to cause placoid corneal endothelial pigmentation so that there was no reason to retrieve a histological specimen. The etiology of this condition remains unknown; however, their inferior corneal location suggests pigment deposition from the iris pigment epithelium.
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