Granular Dystrophy Workup

  • Author: Natalie Afshari, MD, MA, FACS; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Jan 26, 2010
 

Other Tests

  • Corneal biopsy (which is not clinically indicated in patients with granular dystrophy) reveals eosinophilic hyaline deposits in corneal stroma. When a corneal transplant is performed, the specimen is submitted for histopathologic evaluation
  • Masson trichrome stains deposits bright red.
  • Optical coherence tomography (OCT) has been used in assessing granular corneal dystrophy[2] and has been used to guide phototherapeutic keratectomy (PTK).[3]
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Histologic Findings

  • When corneal specimens are obtained, light microscopy reveals eosinophilic hyaline deposits in the corneal stroma; the source of hyaline material is still unknown.
  • Masson trichrome stains the deposits bright red.
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Contributor Information and Disclosures
Author

Natalie Afshari, MD, MA, FACS  Associate Professor of Ophthalmology, Duke University Eye Center, Duke University Medical Center

Natalie Afshari, MD, MA, FACS is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Medical Association, American Society of Cataract and Refractive Surgery, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Coauthor(s)

William B Trattler, MD  Ophthalmologist, The Center for Excellence in Eye Care; Volunteer Assistant Professor of Ophthalmology, Bascom Palmer Eye Institute

William B Trattler, MD is a member of the following medical societies: American Academy of Ophthalmology and American Society of Cataract and Refractive Surgery

Disclosure: Allergan Consulting fee Consulting; Alcon Consulting fee Consulting; Inspire Consulting fee Consulting; Abbott Medical Optics Consulting fee Consulting

William Lloyd Clark, MD  Consulting Staff, Palmetto Retina

William Lloyd Clark, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Specialty Editor Board

Fernando H Murillo-Lopez, MD  Senior Surgeon, Unidad Privada de Oftalmologia CEMES

Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Christopher J Rapuano, MD  Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Director of the Cornea Service, Co-Director of Refractive Surgery Department, Wills Eye Institute

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Cornea Society, Eye Bank Association of America, International Society of Refractive Surgery, and Pan-American Association of Ophthalmology

Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; RPS Ownership interest Other; EyeGate Pharma Consulting fee Consulting; Bausch & Lomb Honoraria Speaking and teaching; Bausch & Lomb Consulting; Merck Honoraria Speaking and teaching

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

  1. Grunauer-Kloevekorn C, Brautigam S, Wolter-Roessler M. Molecular genetic analysis of the BIGH3 gene in lattice type I (Biber-Haab-Dimmer) and granular type II (Avellino) corneal dystrophy: is indirect mutation analysis for hot spots recommended?. Klin Monatsbl Augenheilkd. Dec 2005;222(12):1017-23. [Medline].

  2. Mori H, Miura M, Iwasaki T, et al. Three-dimensional optical coherence tomography-guided phototherapeutic keratectomy for granular corneal dystrophy. Cornea. Sep 2009;28(8):944-7. [Medline].

  3. Dalton K, Schneider S, Sorbara L, Jones L. Confocal microscopy and optical coherence tomography imaging of hereditary granular dystrophy. Cont Lens Anterior Eye. Nov 27 2009;[Medline].

  4. Das S, Langenbucher A, Seitz B. Excimer laser phototherapeutic keratectomy for granular and lattice corneal dystrophy: a comparative study. J Refract Surg. Nov-Dec 2005;21(6):727-31. [Medline].

  5. Albert D, Jakobiec F. Principles and Practice of Ophthalmology. Vol 1. 1994:26-49.

  6. Klintworth GK. Advances in the molecular genetics of corneal dystrophies. Am J Ophthalmol. Dec 1999;128(6):747-54. [Medline].

  7. Krachmer J. Cornea. Vol 2. 1996.

  8. Yamamoto S, Okada M, Tsujikawa M, et al. The spectrum of beta ig-h3 gene mutations in Japanese patients with corneal dystrophy. Cornea. May 2000;19(3 Suppl):S21-3. [Medline].

 
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Granular dystrophy. Image courtesy of James J Reidy, MD, FACS, Associate Professor of Ophthalmology, State University of New York, School of Medicine & Biomedical Sciences, Buffalo, New York.
The slit lamp parallelipid demonstrates the deposition of opacities throughout the central stroma.
 
 
 
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