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in Map-Dot-Fingerprint Dystrophy
Resembling Keratoconus
Arie L. Marcovich1,2, Ori Mahler1,2,
Ayala Pollack1, Samuel Levinger2
Department of Ophthalmology, Kaplan Medical Center
Rehovot, Israel
2
Enaim Laser Surgery, Tel Aviv & Jerusalem, Israel
1
No Financial Interest
Background
In map-dot-fingerprint dystrophy, the
corneal epithelium above an abnormal
basement membrane, is not firmly
attached to the underlying stroma, and
may cause recurrent erosions.
Irregular epithelium can reduce vision
Purpose
To report 2 patients with map-dot-fingerprint
corneal dystrophy with asymmetrical
topographies that resembled keratoconus
Patient 1
A 38 year-old female underwent corneal topography due
to blurred vision in both eyes.
Best corrected visual acuity was: OD 20/40 cc - 3.75 D
OS 20/30 cc - 2.25 D
Topography demonstrated superior asymmetry and the
patient was referred to our cornea service with the
diagnosis of keratoconus.
EyeSys
topography
Patient 1
Patient 1
On slit examination: In both corneas, signs of map-dotfingerprint dystrophy were present.
OD
OS
Patient 2
A 41 year-old female complained of blurred vision in her right eye.
She underwent extensive medical work-up including fluorescein
angiography and MRI scan that were normal. Corneal topography
was performed due to newly detected astigmatism in her right eye.
20/50
Patient 2
Orbscan did not demonstrate posterior keratoconic changes.
Patient 2
The patient underwent alcohol 20% assisted epithelial
removal. Best corrected visual acuity improved to 20/20.
Recurrent erosions did not recur in a one year follow up.
Corneal topography demonstrated regular astigmatism.
20/50
OD inferior steepening
misdiagnosed as keratoconus
:Conclusions
Map-dot-fingerprint dystrophy may
cause blurring of vision and
astigmatism due to epithelial
irregularity, and induce topographic
changes that may mimic keratoconus.
Asymmetry on topography may lead to
misdiagnosis of keratoconus.