A 50-year-old woman with a 6-year history of corneal erosions in OI of unknown origin.
In November 2004, the patient presented with OI pain, highlighting a visual acuity (VA) of 1 and a temporal-superior erosion near the limbus.
The bulbar conjunctiva has two conjunctival dressings in temporal and inferior quadrants.
The cornea shows diffuse subepithelial pigmentation, more pronounced in the periphery and superior and temporal limbus, without corneal vascularization.
Erosion is treated with de-epithelialization, therapeutic contact lens (CTL), and hyaluronic acid eye drops, autologous serum 20%, antiedema and micrometalone recurrence in the latter area for 2 weeks.
In May 2005 the patient was added to the treatment of hypoxia 100 mg/24 h and vitamin C 1 gr/24 h due to peripheral upper nasal erosion.
A temporary erosion occurred in July 2005.
In December 2005, the patient presented a very painful upper nasal corneal erosion with extensive deepithelialisation; pigment was observed at the base of the ulcer.
The corneal epithelium is sent to pathology showing melanic cells HMB-45 positive characteristic of seizures.
The reepithelialization of this area is accompanied by intense local pigmentation.
In February 2006, a lower temporal lumbar biopsy was performed, showing squamous conjunctival mucosa and hyperpigmentation basal ganglia, non-conjunctive colitis due to abnormal deposits and corneal biopsy in the same quadrant.
During the evolution the patient maintains continuous OI discomfort and progression of corneal pigmentation with a slight decrease of OI AV to 1 (-3).
In March 2006, treatment was initiated with 0.02%/8h mitomycin C eye drops and 8h fluorometalone eye drops for two weeks, repeating this cycle one more week with an interval of 3 weeks.
Biomicroscopically, conjunctival pigmentation disappeared, but corneal infection persisted, accompanied in 2008 by recurrence of superotemporal and supero-nasal corneal erosion.
