Systemic sclerosis, secondary Sjogrens syndrome with corneal oedema: A case report

Sridhar Mittanamalli

Pdf Page Numbers :- 160-163

 ¹Department of Ophthalmology, Krishna Institute of Medical Sciences, Minister Road, Hyderabad, Telangana, India

*Corresponding author: Dr. MS. Sridhar, MD., Department of Ophthalmology, Krishna Institute of Medical Sciences, Minister road, Hyderabad, Telangana, India. Tel.: 040-44885050; Fax: 04027840980; Mobile: 91-9849744286; Email: sri.vision@yahoo.co.in

Received 01 August 2016; Revised 08 September 2016; Accepted 15 September 2016; Published 29 September 2016

Citation: Sridhar MS. Systemic sclerosis, secondary Sjogren’s syndrome with corneal oedema: A case report. J Med Sci Res. 2016; 4(4):160-163. DOI: http://dx.doi.org/10.17727/JMSR.2016/4-035

Copyright: © 2016 Sridhar MS. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Purpose: To present a case of systemic sclerosis with asymmetrical skin involvement, decreased tear production not responding to topical cyclosporine therapy and corneal edema in one eye.

Methods: An 84 years old female diagnosed with scleroderma two years ago presented with history of decreased vision in the left eye of 10 days duration.

Results: She had generalised tight skin which was more on the left side. The skin of the face including the eyelids was tight. Her best corrected visual acuity was 20/30, N6 in the right eye and in the left eye, it was 20/200. The Schirmer’s test without anaesthesia revealed a value of 3 mm in the right eye and 1 mm in the left eye. Anterior segment evaluation showed clear cornea with no guttata in the right eye. In the left eye, there was stromal oedema involving inferior half of the cornea with superficial blood vessels inferiorly. Both the corneas showed central superficial punctuate keratopathy. Anterior segment optical coherence tomography showed normal cornea in the right eye, whereas in the left eye there was hyper-reflectivity at the level of Descemet’s membrane suggestive of increased fibrosis and the corneal thickness was more.

Conclusions: Systemic sclerosis can present with asymmetrical skin involvement, decreased tear production not responding to topical cyclosporine therapy and corneal edema in one eye. Further studies are warranted to develop treatment strategies of managing corneal edema in systemic sclerosis.

Keywords: systemic sclerosis (SSc); scleroderma; secondary Sjogren’s syndrome; corneal oedema; anterior segment optical coherence tomography