Corneal dermoid: case report and review of classification

Limbal dermoid epithelium shares phenotypic characteristics common to both hair epidermal and limbal epithelial stem cells

PURPOSE

To determine putative limbal epithelial stem cell marker expression in human limbal dermoids compared to stem cell niches in normal limbus and hair follicles of normal human dermis.

METHODS

Human limbal dermoids (n = 7), normal skin (n = 2) and normal limbal (n = 7) tissue were examined. Immunohistochemistry was performed on paraffin embedded specimens using automated and manual immunostaining with primary antibodies to CK15, CK14, Cadherin-P (CDH3), Wnt-3, Wnt-4, Wnt-5a, Dickkopf (DKK)-3, Sox-2, Sox-10, Sox-13, PEDF, NGFR p75 and β-catenin.

RESULTS

Positive immunostaining was found for CK15, CK14, CDH3, NGFR p75, PEDF, Sox-2, Sox-10 and Wnt 4 in the basal dermoid epithelium, limbus and hair follicles. Suprabasal epithelium was immunostained with PEDF, Sox-2 and Wnt-4 in these tissues. The sebaceous and sweat glands, vascular endothelium and nerves of the limbal dermoid immunostained with PEDF and Sox-2. Sebaceous and sweat glands stained for Sox-10. DKK-3 immunostaining occurred in the dermoids' suprabasal epithelium and vascular endothelium but not in the limbus or hair follicle.

CONCLUSION

Human limbal dermoids share a similar antigenic expression profile similar to the basal limbal epithelium and to the stem cell niche of hair follicles. This supports the notion that limbal dermoids could have properties in common with limbal and/or dermal epithelial stem cells.

Congenital cystic eye: from prenatal diagnosis to therapeutic management and surgical treatment

Only 28 cases of congenital cystic eye have been reported in the literature. The main issue in such cases is differential diagnosis between this malformation and different cystic malformations and masses of the orbital cavity and eyeball, the most common of which is microphthalmia with cyst. Both malformations arise from incomplete closure of the fetal optic vesicle in different stages of embryonic development. We present a case of congenital cystic eye, associated with coloboma and corneal dermoid of the fellow eye and with left brachiocephaly, discussing differential diagnosis with microphthalmia with cyst and illustrating the treatment we planned and performed. The patient first underwent a surgical excision of the left corneal dermoid, then a resection of the right orbital cyst. The last step was to perform a craniotomy and cranial vault remodeling. All the operations were planned and performed using a team approach. The team comprised an ophthalmologist, a plastic surgeon, and a neurosurgeon, and the result was a successful outcome.

Corneal stem cells and their origins: significance in developmental biology

Adult corneal stem cells (SCs) have been the subject of substantial research over the past 2 decades, with promising clinical applications being devised, refined, and tried. However, there have been few studies on the early development of these cells in humans, perhaps due to ethical and practical constraints. This review highlights work that has yielded significant insights from developmental studies in the cornea and other SC repositories. This field merits further research to improve our current knowledge of the origin of SCs, their location, phenotype, function, and niche structure, as well as providing fresh insight into the pathogenesis of congenital diseases and new therapeutic avenues for treating a range of blinding corneal diseases.

Central corneal dermoid in a Labrador retriever puppy

An eight-week-old, male Labrador retriever puppy was presented with an abnormal appearance of the left cornea, observed after the eyelids opened in the second week of life. Ocular examination showed a large central dermoid of the left cornea. The dermoid was excised by superficial keratectomy, and healing was uneventful. The dermoid was classified as a Mann's second type. To the authors' knowledge, a Mann's second type corneal dermoid has not previously been reported in a dog.

Corneal Perforation in a Premature Infant

BACKGROUND

Few cases of corneal perforation in a premature infant have been described in the literature.

METHODS

Identical twins were born at 30-weeks gestation. One twin developed a corneal epithelial defect, infiltration, and perforation with extrusion of intraocular contents, requiring an emergency penetrating keratoplasty. The second twin developed a progressive corneal opacity, requiring a lamellar keratectomy.

RESULTS

After penetrating keratoplasty, the patient developed absolute glaucoma with buphthalmos, leading to enucleation. The twin's lamellar keratectomy specimen proved to be a dermoid.

CONCLUSIONS

One must be aware of the danger of the development of spontaneous corneal perforation with extrusion of intraocular contents in premature infants presenting at birth with an epithelial defect.