Atlas of Ophthalmology

Thygeson's Superficial Punctate Keratitis (Colour Photography Anterior Segment, Slit Lamp)

Cornea -> Keratitis, Infectious/ Non-Infectious
Patient: 32 years of age, male, BCVA 0.8 at OD, 1.0 at OS. General Medical History: empty. Ocular Medical History: resolution of epithelial lesions and symptoms while using topical corticosteroids within last 6 months. Main Complaint: stitching. Purpose: to present an superficial punctate keratitis. Methods: Colour photography anterior segment, slit lamp. Findings: Colour photography anterior segment: slightly elevated, grayish-white subepithelial opacities, highly reflective dots in the epithelium, no conjunctival congestion. Slit lamp: several rough punctate intraepithelial opacities, slightly above the niveau of the surrounding epithelium. Discussion: Thygeson's superficial punctate keratitis (TSPK) is a chronic disease with exacerbations and remissions over years. Hallmarks include multiple, whitish-gray, intraepithelial corneal lesions with minimal conjunctival involvement. Etiology is controversial. Thygeson's superficial punctate keratitis has a genetic association with HLA-DR3, an antigen associated with immunogenic responses. Treatment consists of artificial tears, corticosteroids, topical cyclosporine, or soft contact lenses. Literature: (1) Duszak RS. Diagnosis and management of Thygeson's superficial punctate keratitis. Optometry. 2007 Jul;78(7):333-8. (2) Jiang C, Wang Z, Zhang Y, Sun X. Clinical analyses of 21 cases of Thygeson's superficial punctate keratitis. Zhonghua Yan Ke Za Zhi. 2015 Mar;51(3):173-7.

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