Superficial hypertrophic dendriform epitheliopathy: a follow-up series.

PURPOSE: To report the interval courses of previously reported cases of superficial hypertrophic dendriform epitheliopathy (SHDE) and to describe 3 new cases of this uncommon entity following penetrating keratoplasty. METHOD: Retrospective chart review. RESULTS: We report follow-up on 3 previously described cases of SHDE, including discussion of cases and their clinical course. All 3 patients had persistent surface abnormalities complicating graft success resulting in poor visual outcomes. Three new cases of SHDE are discussed with a summary of the ocular findings and treatment. All patients underwent multiple penetrating keratoplasties for recurrent graft failures resulting from chronic postkeratoplasty surface keratopathy. CONCLUSIONS: SHDE is a rare complication of penetrating keratoplasty that can lead to delayed healing, chronic derangement of the corneal surface, corneal scarring, and an increased risk of graft rejection. Understanding and recognizing this entity is crucial for maximizing graft outcomes. Further investigation of the pathogenesis is necessary for complete understanding and management of the disorder.

The prevalence of ocular signs in acne rosacea: comparing patients from ophthalmology and dermatology clinics.

PURPOSE: To describe and compare the ocular signs in patients diagnosed with acne rosacea by the ophthalmologist with the ocular signs in the patients diagnosed with rosacea by the dermatologist. METHODS: We reviewed the medical records of 176 randomly selected patients diagnosed with rosacea at the University of California, Davis, Medical Center: 88 patients each from the Department of Dermatology and the Department of Ophthalmology. Of the 88 patients diagnosed with acne rosacea by a dermatologist, 22 (25%) had an ophthalmologic evaluation done prior to the study. In those patients without an ophthalmologic assessment, ocular complaints noted by the dermatologist were recorded. We recorded ocular signs including lid, conjunctival, corneal, episcleral, and scleral manifestations as well as charted observations of the iris, lens, intraocular pressures (IOPs), best corrected visual acuity (VA), and funduscopic examination. Age and sex were recorded from the initial ophthalmologic evaluation. The analysis was designed to compare the prevalence of signs and symptoms in two clinical settings. RESULTS: The prevalence of documented meibomian gland dysfunction (p < 0.001), telangiectasia (p = 0.004), and anterior blepharitis (p = 0.008) was significantly higher in ophthalmology patients when compared with dermatology patients. Of the conjunctival signs evaluated, only the presence of interpalpebral conjunctival hyperemia (p = 0.005) was found to be significantly higher in ophthalmology patients. The corneal, episcleral, scleral, and lens findings did not demonstrate a statistically significant difference between groups. CONCLUSION: The major and most easily observable ocular problems in rosacea patients presenting either to ophthalmology or dermatology are lid disease-related manifestations. As might be expected, eye signs and symptoms are more commonly noted in the eye clinic. A clinician's increased awareness of the common ocular findings of rosacea, however, may aid in earlier diagnosis and treatment of ocular rosacea.