007 Prolifération diffuse cornéo-conjonctivale – du vieux vin dans une bouteille neuve ?

Abstract

Objective To study and present a previously unrecognized benign bilateral widespread conjunctival and corneal proliferative condition with a potential to affect vision. Methods A gradually progressive diffuse conjunctival proliferation extending on the cornea was noted in 16 patients (30 eyes). These patients were followed up for a mean of 6.5 years for the site, extent, and progression of the condition. Eight eyes had these lesions removed and studied histopathologically. Results Patients included 8 men and 8 women (mean age, 57 years). Two patients had bilateral nasal lesions only, 1 patient had bilateral temporal lesions only, 8 patients had both nasal and temporal lesions, and 5 patients had lesions that extended circumferentially. Pathological examination showed dense collagenous tissue, a moderate number of active fibroblasts, numerous blood vessels, and no elastotic degeneration in 5 of the 7 eyes. Two eyes showed mild subepithelial elastotic degeneration, and 1 lesion was difficult to interpret because of excessive intraconjunctival hemorrhage. None showed any inflammatory activity. In two patients the lesions showed early signs of recurrence following excision and was treated with intralesional 5FU injection. Conclusions The lesions appear to be a clinical variant of classic pterygium with the corneal encroachment being wider, irregular, and more extensive. Histologically, a noninflammatory nonelastotic collagenous accumulation appears to be a predominant feature unlike in classic pterygium where elastotic degeneration is the predominant feature.