Whorl pattern keratopathies in veterinary and human patients

Fonte: Soohyun Kim, Sara M. Thomasy, David Ramsey, Min Zhao, Mark J. Mannis, Christopher J. Murphy

Pigmentary vortex keratopathy in dogs. A whorl patterned distribution of faint white corneal epithelial opacity with pigmentation in both clockwise and counterclockwise directions is present in the central cornea. A, Right eye of 9-year-old spayed female Shih-Tzu,(B) Left eye of 14-year-old neutered maleMiniature Poodle, (C) Right eye of 4-year-old neutered male Shih-Tzu, (D) Right eye of 12-year-old spayed female Shih-Tzu. Note that in this image, the whirling pigment pattern follows a counterclockwise path along most of its course.
   Pigmentary vortex keratopathy in dogs. A whorl patterned distribution of faint white corneal epithelial opacity with pigmentation in both clockwise and counterclockwise directions is present in the central cornea. A, Right eye of 9-year-old spayed female Shih-Tzu,(B) Left eye of 14-year-old neutered maleMiniature Poodle, (C) Right eye of 4-year-old neutered male Shih-Tzu, (D) Right eye of 12-year-old spayed female Shih-Tzu. Note that in this image, the whirling pigment pattern follows a counterclockwise path along most of its course.

The course travelled by corneal epithelial cells from their stem cell niche at the limbus toward the vertex of the cornea is normally not evident due to their transparency, but in certain conditions, the epithelial cells can be rendered visible to the clinician. In such cases, the pathway taken by epithelial cells can manifest asa whorl pattern described using a variety of terms including hurricane keratitis/keratopathy, vortex keratopathy, whorl keratopathy, cornea verticillata, and at times, named after causative agents as exemplified by amiodarone keratopathy.Here, we briefly discuss the terminology used and the spectrum of conditions that can result in keratopathies with whorl patterns in human patients. We review the manifestations of such patterns in veterinary patients and discuss the state of understanding of the underlying forces that create the whorl distribution of epithelial cells on the ocular surface.

 

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