Título

FURROW DEGENERATION: A CASE REPORT

Objetivo

To report a case of a rare senile peripheral corneal degeneration known as Furrow's degeneration (FD), addressing its main differential diagnoses.

Relato do Caso

Male, 67 years old, white. Without any complaints, comes for routine consultation. On ocular examination, he presented best corrected visual acuity of 1.0 in both eyes. Subjective refraction was (OD) +0,50 -1,25x140 , and (OS) +0,75-1,00x155 Biomicroscopy showed a complete circumferential thinning of the peripheral cornea in both eyes, in the shape of a crescent, between the senile arch and the limbus, with intact epithelium (negative fluorescein test), without anterior chamber reaction. (Figure 1). Biomicroscopy showing circumferential peripheral thinning in both eyes (Figure 2). Corneal Topography showing irregular astigmatism in both eyes. The patient was counseled on the non-inflammatory and non-progressive nature of the disease and its subsequent asymptomatic presentation, advised on general care and annual follow-up.

Conclusão

Furrow's Degeneration is commonly seen as a finding in a slit-lamp examination, but it is essential that the diagnosis is elucidated and differentiated from other similar pathologies such as Terrien's Marginal Degeneration (TMD) and Pelucid Marginal Degeneration (PMD) , since they are pathologies that can occur with perforation and low visual acuity. Corneal thinning in TMD occurs in 5 stages, beginning with a bilateral thinning of the superior portion of the cornea. The thinning progresses slowly, eventually leading to the thinning extending throughout the whole corneal circumference and opacification of the central cornea, with possibility of vision loss and perforation. In contrast, FD will have an intact epithelium and circumferential thinning in the lucid interval between the limbus and the corneal arcus in each eye without vision loss or significant findings on slit-lamp examination. The history and slit-lamp examination provide enough information to differentiate between both pathologies due to the more common presenting symptom of vision loss in TMD.