Summary:
Purpose: The evaluation of clinical manifestations and therapeutical modalities
Thygeson´s keratitis (Thygeson´s superficial punctate keratitis - TSPK) in a group
of patients with long follow-up in the Cornea and Immunology Clinic of the Department
of Ophthalmology, General Teching Hospital, Charles University in Prague.
Patients and Methods: The group of 7 patients (13 eyes) at the mean age of 20,7
years (9-39) with clinical diagnosis of TSPK was evaluated retrospectively. The
course of the disease, symptoms and signs of the disease, efficacy of the therapy
and primary established diagnosis were evaluated.
Results: The average onset of the disease was 12,5 years (6-27) and the average
duration was 6 years (2-10). TSPK was bilateral in six patients, while unilateral
the disease was only in one patient. The clinical picture was characterized by recurrent episodes of photophobia, tearing and burning and foreign body sensation
in the eyes. The examination revealed whitish fine granular asterisk-form or
dendriform intraepithelial opacities, sometimes slightly above the niveau of the
surrounding epithelium. In the acute phase the corneal epithelium above the
lesions was disrrupted. Subjective symptoms and sometime also the objective
findings diminished after local corticosteroids administration. The most common
primary diagnoses the TSPK patients were treated for herpetic keratitis.
Conclusion: TSPK is a rare, relapsing corneal disease with the onset mostly in the
first and third decade of life. TSPK is mostly bilateral, but may be also unilateral
and findings are asymetrical in almost all cases. Relapses frequently occur in
connection with physical or psychological stress. Concerning the permanent
damage to the cornea and potential to decrease visual acuity TSPK can be
considered as a benign and during several years self-limited disease. Subjective
symptoms however may significantly deteriorate patient´s quality of life. Local
treatment with corticosteroids diminishes subjective symptoms, number and
duration of relapses but does not cure the disease. The disease is often misdiagnosed
and treated incorrectly.
Key words:
Thygeron’s keratitis, keratitis superficialis punctata, corticoids
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