Subject: Basic medicine
Year: 2023
Type: Article
Type: PeerReviewed
Title: Corneal distrophy Groenow-i
Author: Gazepov, Strahil
Author: Velickovska, Dragana
Author: Gorgiev, Alen
Abstract: We are talking about corneal dystrophy if there is clouding of its media without them being inflamed beforehand. Corneal dystrophies are diseases that affect the cornea, they are genetic diseases and most of them are autosomal dominant, bilateral and affect only one layer of the cornea. The signs of the disease appear mostly in the first decade of life, but in some forms it can also occur at an older age. About 10% of sufferers develop recurrent corneal erosions in the third decade, while more can spend a lifetime without any noticeable symptoms. There are a large number of corneal dystrophies, but they are still divided into three basic groups depending on the affected layer of the cornea. The layers involved are the epithelial and subepithelial layer, Bowman's layer, stromal, Descemet's membrane and endothelial layer. A different form of the disease has its own physical pathology, signs and symptoms, so their treatment is also different. The mutation of the genes on different parts of the affected chromosomes are the reason for the appearance of corneal dystrophies. Among the most common symptoms that appear in sufferers are blurred vision, the feeling of a foreign body in the eye, repeated erosions and increased sensitivity during the placement of corneal lenses. When repeated erosions of the cornea occur, patients feel pain, photophobia, increased tearing of the eye, redness, a decrease in visual acuity that can lead to people waking up from sleep. This paper explains the signs and symptoms that appear in patients with presence of Groenow stroma corneal dystrophy type I. Granular corneal dystrophy type 1 is an autosomal dominant hereditary disease. It occurs as a result of a mutation of the TGFBI (transforming growth factor beta induced) gene. Heterozygotes have a milder form of the disease than homozygotes. Histologically, accumulations outside the cells of the cornea can be seen in the form of crystalloid orange-amorphous hyaloid. The diagnosis and therapy is variable and depends on the type of corneal dystrophy, the mutated genes that contribute to its development, as well as the damaged layer of the cornea. The leading symptom is the clouding of the cornea, which leads to a decrease in visual acuity, but there are also patients who are asymptomatic and corneal changes can be detected during an ophthalmological examination with a slit lamp. Granular corneal dystrophy is manifested by photophobia and progressive vision loss. They appear in the first decade of life, and begin to bother the patient and become visible in puberty. Repetitive erosions occur less often in this form of ocular dystrophy, and the sensitivity of the cornea gradually decreases. On examination, white milky opacities in the form of grains located under Bowman's membrane can be seen, and the cornea between the grains is transparent. The central parts of the cornea are affected and gradually over many years it spreads towards the periphery and penetrates deeper into the cornea. This form of dystrophy is diagnosed with the help of symptoms as well as corneal changes, histological results, and maybe with electron microscopy where intraepithelial cytoplasmic granules in a rod or trapezoid shape can be observed. There is no medicine that could stop the progression of the disease. Lamellar or penetrating keratoplasty is the primary therapy. Surgical treatment is undertaken when visual acuity becomes unusable, which is usually around age 40. In other forms of corneal dystrophy, therapy mainly consists in treating recurrent corneal erosions. Application of local ointments, hypertonic agents, therapeutic contact lenses as non-conservative methods, while the invasive treatment includes lamellar keratoplasty, anterior stromal puncturing, superficial keratectomy, photorefractive keratectomy, diamond polishing ("diamond burr polishing"). As a non-invasive therapy that gives good success is therapy with an autonomous serum containing fibronectin, which prevents recurrent erosion, improves vision by gradually removing the opacity of the cornea, as well as reducing the pain that appears during corneal erosion. Keywords: dystrophy, cornea, genes, Groenow type I, keratoplasty.
Publisher: KNOWLEDGE - International Journal Scientific
Relation: https://eprints.ugd.edu.mk/31651/
Identifier: oai:eprints.ugd.edu.mk:31651
Identifier: https://eprints.ugd.edu.mk/31651/1/CORNEAL%20DISTROPHY%20GROENOW-I.pdfIdentifier: Gazepov, Strahil and Velickovska, Dragana and Gorgiev, Alen (2023) Corneal distrophy Groenow-i. Knowledge - International Journal Scientific Papers, 57 (4). pp. 573-578. ISSN 1857-923X
Identifier: ISSN 2545 – 4439
