Mehrdad Mohammadpour1, Mohammad-Ali Javadi. 1. Ophthalmic Research Center, Labbafinejad Medical Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Abstract
PURPOSE: To report an 8-year-old girl with bilateral progressive visual loss and photophobia secondary to stem cell deficiency as a result of multiple endocrine deficiency. METHODS: A case report and review of medical literature. RESULTS: The patient suffered from severe photophobia and decreased visual acuity since May 2000. Despite multiple outpatient visits, no definite cause was found, and conservative treatments failed. On slit-lamp examination severe meibomian gland dysfunction, loss of eyelashes, decreased tear meniscus, diffuse corneal vascularization, and delayed punctate fluorescein staining of corneal epithelium were detected. She had also episodes of hypotension, oral candidiasis, and seizures. Her systemic work up revealed multiple endocrine deficiency (Addison disease and hypoparathyroidism). Hormone replacement therapy with fludrocortisone and oral calcium accompanied by punctual occlusion led to significant clinical recovery. CONCLUSION: In a pediatric patient with diffuse corneal vascularization and no definite cause, systemic workup should be done to rule out multiple endocrine deficiencies. Treatment consists of hormone replacement therapy and management of the dry eye.
PURPOSE: To report an 8-year-old girl with bilateral progressive visual loss and photophobia secondary to stem cell deficiency as a result of multiple endocrine deficiency. METHODS: A case report and review of medical literature. RESULTS: The patient suffered from severe photophobia and decreased visual acuity since May 2000. Despite multiple outpatient visits, no definite cause was found, and conservative treatments failed. On slit-lamp examination severe meibomian gland dysfunction, loss of eyelashes, decreased tear meniscus, diffuse corneal vascularization, and delayed punctate fluorescein staining of corneal epithelium were detected. She had also episodes of hypotension, oral candidiasis, and seizures. Her systemic work up revealed multiple endocrine deficiency (Addison disease and hypoparathyroidism). Hormone replacement therapy with fludrocortisone and oral calcium accompanied by punctual occlusion led to significant clinical recovery. CONCLUSION: In a pediatric patient with diffuse corneal vascularization and no definite cause, systemic workup should be done to rule out multiple endocrine deficiencies. Treatment consists of hormone replacement therapy and management of the dry eye.
Authors: Sophie X Deng; Vincent Borderie; Clara C Chan; Reza Dana; Francisco C Figueiredo; José A P Gomes; Graziella Pellegrini; Shigeto Shimmura; Friedrich E Kruse Journal: Cornea Date: 2019-03 Impact factor: 2.651
Authors: Ruchi Shah; Cynthia Amador; Kati Tormanen; Sean Ghiam; Mehrnoosh Saghizadeh; Vaithi Arumugaswami; Ashok Kumar; Andrei A Kramerov; Alexander V Ljubimov Journal: Exp Eye Res Date: 2021-01-21 Impact factor: 3.467