Meesmann Corneal Dystrophy; a Clinico-Pathologic, Ultrastructural and Confocal Scan Report

Purpose: to report the microstructural features of meesmann corneal dystrophy(mcd) in two patients.case report: the first patient was a 10-year-old boy who presented with bilateralvisual loss, diffuse corneal epithelial microcystic changes, high myopia and amblyopia.with a clinical impression of mcd, automated lamellar therapeutic keratoplastywas performed in his left eye. histopathologic examination of the corneal buttondisclosed epithelial cell swelling and cyst-like intracytoplasmic inclusions. the cellscontained moderate amounts of periodic acid-schiff-positive and diastase-sensitivematerial (glycogen). transmission electron microscopy revealed numerous vacuolesand moderate numbers of electron-dense membrane-bound bodies in the cytoplasm,similar to lysosomes, some engulfed by the vacuoles. the second patient was a17-year-old female with a clinical diagnosis of mcd and episodes of recurrent cornealerosion. on confocal scan examination of both corneas, hyporeflective round-shapedareas measuring 6.8 to 41.4(mu)m were seen within the superficial epithelium togetherwith irregular and ill-defined high-contrast areas in the sub-basal epithelial region.the subepithelial nervous plexus was not visible due to regional hyperreflectivity.conclusion: this case report further adds to the microstructural features of meesmanncorneal dystrophy and suggests confocal scan as a non-invasive method for delineatingthe microstructural appearance of this rare dystrophy.