title: Salzmann's Nodular Degeneration.
abstract: Salzmann's nodular degeneration (SND) is a rare, noninflammatory, slowly progressive degenerative disease of the cornea that is characterized by the appearance of nodular bluish gray opacities that vary in number and size. It is usually bilateral; most commonly occurring in people aged 50-60 years old, with a female preponderance; and often associated with a history of prior corneal inflammation. The clinical features usually depend on the location of the nodules. Generally, the nodules of SND are bluish white to gray in color, 1-2 mm in size, and round, conical or prismatic in shape. The overlying Bowman's layer is usually absent from the nodular areas and is partially replaced by granular Periodic Acid Schiff-positive eosinophilic material resembling the basement membrane. Diagnostic investigations include ultrasonic pachymetry, anterior segment optical coherence tomography, ultrasound biomicroscopy, and confocal microscopy. The majority of patients respond well to conservative management with topical lubricants; severe cases may require surgical intervention. The various surgical modalities described include superficial keratectomy, which may be combined with phototherapeutic keratectomy and keratoplasty. Various modifications of these procedures include the use of alcohol-assisted epithelial delamination, intraoperative mitomycin-C or amniotic membrane transplantation to make the procedure easy, reduce the risk of recurrence and improve postoperative comfort. Recurrences are rarely reported; overall, the visual prognosis following treatment is optimal.
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Prafulla K
authors.initials: PK
authors.lastname: Maharana
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. Electronic address: namrata.sharma@gmail.com.
authors.forename: Namrata
authors.initials: N
authors.lastname: Sharma
authors.affiliation: L. V. Prasad Eye Institute, Bhubneswar, Orissa, India.
authors.forename: Sujata
authors.initials: S
authors.lastname: Das
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Tushar
authors.initials: T
authors.lastname: Agarwal
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Seema
authors.initials: S
authors.lastname: Sen
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Prakash
authors.affiliation: Vision Eye Institute, Royal Victorian Eye and Ear Hospital, North West Academic Centre, University of Melbourne, Australia.
authors.forename: Rasik B
authors.initials: RB
authors.lastname: Vajpayee
mesh_terms: D003317:Corneal Dystrophies, Hereditary / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D014943:Global Health; D006801:Humans; D015994:Incidence; D033401:Microscopy, Acoustic; D018613:Microscopy, Confocal; D012008:Recurrence; D014792:Visual Acuity / Q000502:physiology*
keywords: Salzmann's corneal degeneration; corneal degeneration; corneal opacities