Partial regression of large anterior scleral staphyloma secondary to rhinosporidiosis after corneoscleral graft - a case report

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Authors: Elaine Fiod Costa, Luciano Moreira Pinto, Marcos Adriano Garcia Campos, Thais Mota Gomes and Gyl Eanes Barros Silva
Date: Feb. 27, 2018
From: BMC Ophthalmology(Vol. 18, Issue 1)
Publisher: BioMed Central Ltd.
Document Type: Clinical report
Length: 1,627 words

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Author(s): Elaine Fiod Costa1 , Luciano Moreira Pinto2 , Marcos Adriano Garcia Campos1 , Thais Mota Gomes1 and Gyl Eanes Barros Silva1

Background

Rhinosporidiosis is a rare chronic infection of the mucous membrane that is caused by the Rhinosporidium seeberi, a microorganism of Mesomycetozoa clade. The common sites affected are nose and nasopharynx, although it may also be present on the eye, ear and even genitalia in both sexes. Approximately 15% of cases of rhinosporidiosis are ocular, and the tarsal conjunctiva is the most common site of infection followed by bulbar conjunctiva, lid, the lacrimal gland, and sclera. [1] The presumed mode of infection is from the aquatic habitat through traumatized epithelium. The disease is worldwide but endemic in Africa and Asia, and most frequent in south India and Sri Lanka. [2] However, sporadic occurrence of the ocular form has been reported in America, particularly United States and Canada. [3, 4]

Bulbar oculosporidiosis represents about 12.4% of the cases and usually presents as polypoidal and vascular masses that bleed even upon touch. The definitive diagnosis is made by microbiological scrapings and histopathological examination of resected tissues. Scleral melting associated with bulbar conjunctival rhinosporidiosis is rare, there have been only 11 cases of scleral melt and staphyloma formation reported in the literature. [1, 5-10] This report describes the partial regression of one of the largest scleral ectasia related to oculosporidiosis infection after a corneoscleral tectonic graft.

Case presentation

A 13-year-old girl from Presidente Juscelino, Maranhão, Brazil with recurrent episodes of irritation, bleeding and watering of the OS for the past 3 years (Fig. 1). She exhibited pain and a progressively increasing mass in the upper nasal area above her left cornea for 2 years. She often swims in ponds and rivers. There was no history of trauma, epistaxis, close contact with animals, or similar masses elsewhere in the body. No contributory medical illnesses were found during the investigation.

Fig. 1:

Timeline of diagnosis, interventions and outcomes [end caption]

On examination, uncorrected Snellen visual acuity was 20/20 in OD and the best-corrected visual acuity was 20/20 in OS with a - 4.75-diopter cylinder at 120 degrees. In OD, slit-lamp biomicroscopy, intraocular pressure and fundus examination were normal. In OS, an oval, bluish swelling measuring 10 x 10 mm and 5 mm in height was seen in the equatorial area of the upper nasal quadrant. There was congestion of the overlying conjunctival and episcleral vessels. Slit-lamp biomicroscopy...

Source Citation

Source Citation
Costa, Elaine Fiod, et al. "Partial regression of large anterior scleral staphyloma secondary to rhinosporidiosis after corneoscleral graft - a case report." BMC Ophthalmology, vol. 18, no. 1, 27 Feb. 2018. Accessed 18 Oct. 2021.
  

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