PERIPHERAL HYPERTROPHIC SUBEPITHELIAL CORNEAL DEGENERATION

Course overview

PERIPHERAL HYPERTROPHIC SUBEPITHELIAL CORNEAL DEGENERATION IS A RARE, BILATERAL, AND SYMMETRIC DISEASE THAT TYPICALLY AFFECTS MIDDLE-AGED WHITE WOMEN WITH A PRIOR HISTORY OF OCULAR SURFACE DISEASE, CONTACT LENS USE, OR OCULAR SURGERY. THE OVERALL INCIDENCE RATE OF THIS RARE DISEASE IS LARGELY UNKNOWN. ALTHOUGH SOMETIMES REGARDED AS A SUBTYPE OF SALZMANN NODULAR DEGENERATION, PERIPHERAL HYPERTROPHIC SUBEPITHELIAL CORNEAL DEGENERATION HAS UNIQUE DIFFERENTIATING FEATURES, SUCH AS MORE PERIPHERAL AND CIRCUMFERENTIAL FIBROTIC SUBEPITHELIAL LESIONS THAT SPARE THE CENTRAL CORNEA AND AN ABSENCE OF ACUTE OR CHRONIC INFLAMMATION ON HISTOPATHOLOGICAL EVALUATION. PATIENTS TYPICALLY PRESENT WITH PROGRESSIVELY WORSENING OCULAR IRRITATION, WORSENING VISUAL ACUITY, OR BOTH. CURRENT PATHOPHYSIOLOGICAL MECHANISMS ARE NOT WELL UNDERSTOOD BUT ARE BELIEVED TO BE DUE TO INCREASED LEVELS OF MATRIX METALLOPROTEINASE-2, SIMILAR TO THE MECHANISMS UNDERLYING SALZMANN NODULAR DEGENERATION. MANAGEMENT STRATEGIES INCLUDE CONSERVATIVE TREATMENTS SUCH AS LUBRICATION FOR MILD CASES WITH UNAFFECTED VISUAL ACUITY AND SURGICAL INTERVENTIONS FOR PATIENTS WITH DECREASED VISUAL ACUITY DUE TO FIBROTIC ENCROACHMENT ON THE VISUAL AXIS.PARTICIPANTS GAIN COMPREHENSIVE KNOWLEDGE ABOUT THE ETIOLOGY, DIAGNOSIS, AND TREATMENT OF PERIPHERAL HYPERTROPHIC SUBEPITHELIAL CORNEAL DEGENERATION, WITH A FOCUS ON EFFECTIVE MANAGEMENT STRATEGIES THROUGH THIS CONTINUING EDUCATION ACTIVITY. EMPHASIS IS PLACED ON THE IMPORTANCE OF COLLABORATION WITHIN AN INTERPROFESSIONAL HEALTHCARE TEAM, AS JOINT EFFORTS BETWEEN OPHTHALMOLOGISTS, OPTOMETRISTS, AND OTHER SPECIALISTS CAN LEAD TO MORE ACCURATE DIAGNOSES AND BETTER TREATMENT PLANS. THIS COLLABORATIVE APPROACH ENSURES THAT PATIENTS RECEIVE TIMELY INTERVENTIONS, IMPROVING THEIR VISUAL OUTCOMES AND OVERALL QUALITY OF LIFE.