Diagnostic Criteria for Terrien Marginal Degeneration: Nordic Terrien Degeneration Study

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dc.contributor.author Ruutila, M
dc.contributor.author Fagerholm, P
dc.contributor.author Lagali, N
dc.contributor.author Hjortdal, J
dc.contributor.author Bram, T
dc.contributor.author Moilanen, J
dc.contributor.author Kivela, TT
dc.date.accessioned 2021-10-20T06:29:01Z
dc.date.available 2021-10-20T06:29:01Z
dc.date.issued 2021-02
dc.identifier.citation Ruutila , M , Fagerholm , P , Lagali , N , Hjortdal , J , Bram , T , Moilanen , J & Kivela , TT 2021 , ' Diagnostic Criteria for Terrien Marginal Degeneration: Nordic Terrien Degeneration Study ' , Cornea , vol. 40 , no. 2 , pp. 133-141 . https://doi.org/10.1097/ICO.0000000000002427
dc.identifier.other PURE: 169630151
dc.identifier.other PURE UUID: b3accde7-29a7-4fa9-8511-50e42e3b5543
dc.identifier.other RIS: urn:23E18B1537A0436D2241F2D282EA46E9
dc.identifier.other WOS: 000658821500001
dc.identifier.uri http://hdl.handle.net/10138/335463
dc.description.abstract Purpose: To refine the diagnostic criteria for Terrien marginal degeneration (TMD) based on experience in 3 Nordic countries. Methods: This is a retrospective, multicenter, hospital-based cross-sectional study of 49 eyes of 29 white patients in tertiary referral centers in Finland, Sweden, and Denmark from 1998 to January 2018. The median follow-up was 3 years. Symptoms, best corrected visual acuity, astigmatism, corneal thickness, curvature and cavities, stage, and progression were analyzed. Results: TMD was diagnosed equally likely between 15 and 86 years of age (median, 47 years). Twenty patients (69%) had bilateral disease, and 62% were men. Seventeen patients (59%) had symptoms including blurred vision and ocular surface disease symptoms without inflammatory signs. Eight patients (28%) had slightly reduced corneal sensitivity. Median best corrected visual acuity was 20/25 (range, 20/16-20/200) and astigmatism was 2.6 diopters (D) (range, 0-10) with a mean progression of 0.41 D per year (range, 0-5.4). Age and astigmatism were not correlated. All eyes had peripheral vascularization, lipid deposits, and hyperreflectivity throughout thinned peripheral stroma and its anterior edge. The thinning progressed in 15 patients (52%). Of 26 patients, 8 (31%) had single or confluent paralimbal intrastromal cavities, most commonly superiorly. By Suveges classification, the stage was 2 (92%) or 3 (8%). Minimum corneal thickness and corneal curvature were loosely associated, leading to different stages in Wang classification in 34 eyes (69%). Conclusions: TMD is defined by peripheral corneal thinning, superficial neovascularization, lipid deposition at the leading edge, absence of ulceration and inflammation, and frequently cavitation. The most sensitive way to follow its progression is anterior segment optical coherence tomography. en
dc.format.extent 9
dc.language.iso eng
dc.relation.ispartof Cornea
dc.rights cc_by
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Terrien marginal degeneration
dc.subject peripheral corneal thinning
dc.subject lipid
dc.subject neovascularization
dc.subject cavities
dc.subject CROSS-LINKING
dc.subject MICROSCOPY
dc.subject 3125 Otorhinolaryngology, ophthalmology
dc.title Diagnostic Criteria for Terrien Marginal Degeneration: Nordic Terrien Degeneration Study en
dc.type Article
dc.contributor.organization Doctoral Programme in Clinical Research
dc.contributor.organization Department of Ophthalmology and Otorhinolaryngology
dc.contributor.organization Silmäklinikka
dc.contributor.organization HUS Head and Neck Center
dc.contributor.organization Clinicum
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1097/ICO.0000000000002427
dc.relation.issn 0277-3740
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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