eMedicine Specialties > Ophthalmology > Cornea

Dystrophy, Lattice: Differential Diagnoses & Workup

Author: Natalie Afshari, MD, MA, FACS, Associate Professor of Ophthalmology, Duke University Eye Center, Duke University Medical Center
Coauthor(s): William B Trattler, MD, Ophthalmologist, The Center for Excellence in Eye Care; Volunteer Assistant Professor of Ophthalmology, Bascom Palmer Eye Institute; William Lloyd Clark, MD, Consulting Staff, Palmetto Retina
Contributor Information and Disclosures

Updated: Jan 26, 2010

Differential Diagnoses

Corneal Erosion, Recurrent
Dystrophy, Granular
Dystrophy, Macular

Workup

Laboratory Studies

  • Genetic analysis performed in research laboratories can reveal the genetic mutation of lattice corneal dystrophy. This is not a routine study at this time.
  • A genetic analysis can determine the specific mutation on the BIGH3 gene of chromosome 5, which can allow for the precise diagnosis of the subtype of lattice dystrophy and can be useful for differentiating lattice dystrophy from Avellino dystrophy, granular dystrophy, and Reis-Bückler dystrophy (all which have mutations of the BIGH3 gene).

Procedures

  • Corneal biopsy, which is not clinically indicated, reveals amyloid in the corneal stroma.

Histologic Findings

  • The deposits are amyloid, which stain orange-red with Congo red.
  • They also stain with periodic-acid Schiff (PAS) and Masson trichrome.
  • Under polarized light, the deposits exhibit birefringence and red-green dichroism.

More on Dystrophy, Lattice

Overview: Dystrophy, Lattice
Differential Diagnoses & Workup: Dystrophy, Lattice
Treatment & Medication: Dystrophy, Lattice
Follow-up: Dystrophy, Lattice
Multimedia: Dystrophy, Lattice
References

References

  1. Stone EM, Mathers WD, Rosenwasser GO, et al. Three autosomal dominant corneal dystrophies map to chromosome 5q. Nat Genet. 1994;6(1):47-51. [Medline].

  2. 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].

  3. Resch MD, Schlotzer-Schrehardt U, Hofmann-Rummelt C, Kruse FE, Seitz B. Alterations of epithelial adhesion molecules and basement membrane components in lattice corneal dystrophy (LCD). Graefes Arch Clin Exp Ophthalmol. Aug 2009;247(8):1081-8. [Medline].

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

  5. Das S, Langenbucher A, Seitz B. Delayed healing of corneal epithelium after phototherapeutic keratectomy for lattice dystrophy. Cornea. Apr 2005;24(3):283-7. [Medline].

  6. Kawashima M, Yamada M, Funayama T, et al. Six cases of late-onset lattice corneal dystrophy associated with gene mutations induced by the transforming growth factor-beta. Nippon Ganka Gakkai Zasshi. Feb 2005;109(2):93-100. [Medline].

  7. Krachmer J. Cornea (3 volume set). Vol 2. 1996.

  8. Mashima Y, Yamamoto S, Inoue Y, et al. Association of autosomal dominantly inherited corneal dystrophies with BIGH3 gene mutations in Japan. Am J Ophthalmol. Oct 2000;130(4):516-7. [Medline].

Further Reading

Keywords

lattice dystrophy, corneal dystrophy, stromal dystrophy, stromal dystrophies, corneal erosion, corneal transplant, phototherapeutic keratectomy, PTK, treatment, diagnosis, symptoms

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: Nothing to disclose.

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.

Medical Editor

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.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Co-Chairman of the Cornea Service, Co-Chairman 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; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other; Vistakon Honoraria Speaking and teaching; EyeGate Pharma  Consulting; Inspire Consulting fee Consulting; Bausch & Lomb Honoraria Speaking and teaching

CME Editor

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.

 
 
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