Keratoconus in Patients with Macular Stromal Dystrophy
Panida Kosrirukvongs MD*, Panotsom Ngowyutagon MD**, Wipawee Booranapong MD*
Affiliation : * Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Department of Ophthalmology, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
Objective : To show the association between keratoconus and macular dystrophy.
Material and Method: All patients with macular dystrophy and associated clinical findings leading to a diagnosis of
keratoconus by corneal topography were retrospectively reviewed during a 10-year period. Uncorrected and best-corrected
visual acuity, automated refraction, manifest refraction, corneal thickness, and corneal curvature by corneal topography
were evaluated.
Results : Three patients with macular dystrophy exhibiting decreased vision, multifocal white dense deposits, and haze
surrounding the deposits in the corneal stroma were evaluated. All had a steep corneal curvature of >47 diopters and a
thin cornea consistent with keratoconus. Penetrating keratoplasty was performed in one patient with severely decreased
vision. Macular dystrophy was diagnosed based on an Alcian blue-stained pathological specimen.
Conclusion : Keratoconus may develop as a result of changes associated with macular dystrophy. Therefore, patients with
severely decreased vision should be evaluated for keratoconus to ensure proper management.
Keywords : Keratoconus, Macular stromal dystrophy, Corneal topography, Corneal thinning
