Corneal cross-linking for treatment of progressive keratoconus in a patient with Alport syndrome: A case report

Eur J Ophthalmol. 2021 Jul;31(4):1584-1587. doi: 10.1177/1120672121997672. Epub 2021 Feb 25.

Abstract

Purpose: Ocular features of Alport syndrome include anterior lenticonus, posterior polymorphous corneal dystrophy, and fleck-and-dot retinopathy in most cases. Keratoconus in such patients has been rarely mentioned in previous studies. To our knowledge, this is the first report of corneal cross-linking for halting the progression of keratoconus in a patient with Alport syndrome.

Case report: A 22-year-old male was referred for his initial corneal topography, after he was already prescribed with rigid gas-permeable contact lenses. Alport syndrome was diagnosed in his infancy and gene COL4A5 mutation was confirmed. Ophthalmological evaluation confirmed keratoconus. One-year follow-up showed a progression on his right eye and standard corneal cross-linking was performed. Stabilization of the disease marked by normalization in visual function and corneal tomography values was noticed 1 year after the procedure.

Conclusions: When diagnosing ocular clinical findings of Alport syndrome, keratoconus should be considered. Standard corneal cross-linking protocol can halt its progression.

Keywords: Corneal topography/imaging systems; cornea/external disease; corneal topography/keratometry; diseases of the ocular surface; ocular surface surgery; refractive surgery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cornea
  • Corneal Dystrophies, Hereditary* / diagnosis
  • Corneal Dystrophies, Hereditary* / drug therapy
  • Corneal Topography
  • Cross-Linking Reagents / therapeutic use
  • Humans
  • Keratoconus* / diagnosis
  • Keratoconus* / drug therapy
  • Male
  • Nephritis, Hereditary* / complications
  • Nephritis, Hereditary* / diagnosis
  • Nephritis, Hereditary* / drug therapy
  • Photochemotherapy*
  • Photosensitizing Agents / therapeutic use
  • Riboflavin / therapeutic use
  • Ultraviolet Rays
  • Young Adult

Substances

  • Cross-Linking Reagents
  • Photosensitizing Agents
  • Riboflavin