Cornea plana commonly presents as a flat cornea, early-onset arcus lipoides, low anterior chamber depth, and an indistinct border between the sclera and cornea due to a decreased angle between the two.[2] Although a small corneal diameter is anticipated, measuring it can be challenging because the scleral tissue overlaps the cornea by a few millimeters. In the patients who have been described, the anterior chamber depth has been found to vary from 0.8 to 2.1 mm.[3]
Moreover, high hyperopia, strabismus, microcornea, posterior embryotoxon, iridocorneal adhesions, iris lumps, iris wasting, and pupillary abnormalities can all be present.[4] Instead of hyperopia, myopia has been identified in a few cases.[5] As many as 90 percent of cases have a bilateral presentation, which is linked to sclerocornea.[1] Finally, congenital ptosis has also been reported, and the absence of corneal protrusion is most likely the cause.[3]
Diagnosis
Clinical presentation, keratometry,[5]pachymetry, and endothelial imaging are used to make the diagnosis.[6]
Since the decreased refraction in the autosomal recessive form is more severe than in the autosomal dominant form, corneal refraction measurements can be used to differentiate between CNA1 and CNA2.[3]
Histology is distinguished by acanthosis, keratinization of the corneal epithelium, Bowman's membrane defects, and stromal vascularization and scar formation.[7]
^ abcdForsius, Henrik; Damsten, Margareta; Eriksson, Aldur W.; Fellman, Johan; Lindh, Sinikka; Tahvanainen, Esa (1998). "Autosomal recessive cornea plana. A clinical and genetic study of 78 cases in Finland". Acta Ophthalmologica Scandinavica. 76 (2). Wiley: 196–203. doi:10.1034/j.1600-0420.1998.760215.x. ISSN1395-3907. PMID9591953.
^Aldave, Anthony J.; Sonmez, Baris; Bourla, Nirit; Schultz, Gerald; Papp, Jeanette C.; Salem, Andrew K.; Rayner, Sylvia A.; Yellore, Vivek S. (2007). "Autosomal Dominant Cornea Plana is not Associated with Pathogenic Mutations inDCN, DSPG3, FOXC1, KERA, LUM,orPITX2". Ophthalmic Genetics. 28 (2). Informa UK Limited: 57–67. doi:10.1080/13816810701351321. ISSN1381-6810. PMID17558846. S2CID23491990.
^ abFogla, Rajesh; Indumathy, Thazethaeveetil R. (2020). "Customized toric intraocular lens implantation in cornea plana". Journal of Cataract and Refractive Surgery. 46 (12). Ovid Technologies (Wolters Kluwer Health): e11 –e14. doi:10.1097/j.jcrs.0000000000000350. ISSN0886-3350. PMID32818351. S2CID221221090.
^Ramappa, Muralidhar; Achanta, Divya Sree Ramya; Mohamed, Ashik; Chaurasia, Sunita (August 18, 2020). "Corneal endothelial alterations in Recessive Cornea Plana: a report of 4 patients and review of literature". Ophthalmic Genetics. 41 (6). Informa UK Limited: 659–662. doi:10.1080/13816810.2020.1804944. ISSN1381-6810. PMID32811257. S2CID221181241.
^Sigler-Villanueva, Aldo; Tahvanainen, Esa; Lindh, Sinikka; Dieguez-Lucena, Jose; Forsius, Henrik (1997). "Autosomal dominant cornea plana: Clinical findings in a Cuban family and a review of the literature". Ophthalmic Genetics. 18 (2). Informa UK Limited: 55–61. doi:10.3109/13816819709057116. ISSN1381-6810. PMID9228241.