Corneal endothelial abnormalities associated with thalidomide toxicity.
OBJECTIVE
To describe bilateral corneal endothelial abnormalities associated with thalidomide toxicity.


METHODS
Observational case report.


RESULTS
A 30-year-old man, born with bilateral hypoplastic upper limb defects (phocomelia) caused by thalidomide toxicity, presented with bilateral symmetrical corneal endothelial changes resembling guttata without corneal edema. Pachymetry, specular microscopy, and confocal microscopy were performed. Biomicroscopy findings over a 10-year follow-up showed no changes.


CONCLUSIONS
Nonprogressive bilateral corneal endothelial changes resembling cornea guttata should possibly be included in the ocular manifestations of thalidomide toxicity. We postulate that thalidomide may have affected the migration and development of the mesenchymal neural crest cells, which are the developmental precursors of the corneal endothelium and stroma.
Srinivasan
Sathish
S
St. Paul's Eye Unit, Royal Liverpool and Broadgreen University Hospitals, NHS Trust, Liverpool L7 8XP, UK. sathish@tiscali.co.uk
Perez-Gomez
Inma
I
O'Donnell
Clare
C
Batterbury
Mark
M
D000014:Abnormalities, Drug-Induced / Q000175:diagnosis / Q000209:etiology*; D000328:Adult; D003316:Corneal Diseases / Q000139:chemically induced* / Q000175:diagnosis; D004480:Ectromelia / Q000139:chemically induced; D004728:Endothelium, Corneal / Q000002:abnormalities* / Q000473:pathology; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D013792:Thalidomide / Q000009:adverse effects*
D013792:Thalidomide