Changes of Clinical Manifestation of Granular Corneal Deposits Because of Recurrent Corneal Erosion in Granular Corneal Dystrophy Types 1 and 2

Abstract

Purpose: To elucidate changes of clinical manifestation of granular corneal deposits after recurrent corneal erosion in granular corneal dystrophy types 1 and 2 (GCD1 and GCD2).

Methods: Six patients (5 patients with GCD2 and 1 with GCD1) were included. Slit-lamp photographs of all patients and Fourier domain optical coherence tomography images of 3 available patients were analyzed. In part II of this study, to evaluate deposit disappearance incidence (becoming annular granular deposits), we counted deposits of another 60 GCD2 heterozygotes according to decade of age as the following subgroups: discoid (filled-up) granular deposits, annular (ring-shaped) granular deposits, and lattice-like lesions.

Results: Granular deposits dropped off singularly during recurrent corneal erosion in GCD2 heterozygotes, becoming annular deposits. In contrast, confluent granular deposits in GCD2 homozygotes and GCD1 patients dropped off in groups. Reaccumulation was observed at the margin of the previously dropped off area in patients who were followed-up for an extended period. Part II of the study showed that annular deposits appeared in the third decade and increased gradually. Discoid granular deposits increased sharply in the 40s age group, and lattice-like lesions increased gradually from the third decade.

Conclusions: The disappearance of granular deposits in GCD1 and GCD2 could be interpreted as evidence of drop-off phenomena with recurrent corneal erosion. With drop off of the deposits, various configurations and morphological changes of corneal deposits can occur in these corneal dystrophies.