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Anales de la Sociedad Mexicana de Oftalmología y Archivos de la Asociación Para Evitar la Ceguera en México

2018, Number 4

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Rev Mex Oftalmol 2018; 92 (4)

Corneal epitheliopathy under diagnosed: Toxic, nutricional and diabetic epitheliopathy

Ramírez-Miranda A, Blas-Medina R

Language: Spanish
References: 37
Page: 173-179
PDF size: 420.95 Kb.


ABSTRACT

There are many causes of corneal epitheliopathies, however, the rare causes are underdiagnosed due to the little knowledge that exists about them. Among these the most frequent is undoubtedly the toxic epitheliopathy, due to the misuse or treatment of some topical medication, exerting its toxic effects directly to cause a superficial punctate keratopathy, or indirectly causing inflammation and interfering with the migration of the epithelial limbal cells. There is a wide range of agents that can cause toxic epitheliopathy, the most known benzalkonium chloride (BAK), highly toxic to the corneal epithelium, strongly associated with toxic epitheliopathy, allergic conjunctivitis and blepharitis. There have been described toxic epithelopathies secondary to chemotherapy specifically with monoclonal antibodies that inhibit the epidermal growth factor receptor (EGFR). The epitheliopathy secondary to vitamin A deficiency is a very important clinical aspect in this pathology, causing an instability of the precorneal tear layer causing a punctate epitheliopathy, which can progress to epithelial defects, stromal edema and keratinization. Diabetes mellitus can lead to several ocular complications, among which is the diabetic epitheliopathy that includes superficial punctate keratopathy and persistent epithelial defects, having an important clinical impact due to the symptoms produced from foreign body sensation to visual impairment. It is important to know this entities for its proper diagnosis and treatment. Search intentionally in ophthalmological practice in cases of persistent epitheliopathies or treatment resistant.


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