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Thiel-Behnke corneal dystrophy
Thiel-Behnke corneal dystrophy (TBCD) is a rare form of superficial corneal dystrophy characterized by sub-epithelial honeycomb-shaped corneal opacities in the superficial cornea, and progressive visual impairment.
- Anterior limiting membrane dystrophy type 2
- Anterior limiting membrane dystrophy type II
- Corneal dystrophy of Bowman layer type 2
- Corneal dystrophy of Bowman layer type II
- Curly fiber corneal dystrophy
- Honeycomb corneal dystrophy
- Waardenburg-Jonker corneal dystrophy
- Prevalence: Unknown
- Inheritance: Autosomal dominant
- Age of onset: Adolescent, Childhood, Adult
- ICD-10: H18.5
- OMIM: 602082
- UMLS: C1562894
- MeSH: C535942
- GARD: 9275
- MedDRA: -
Prevalence of this form of corneal dystrophy is not known. Cases have been reported in Germany, the USA and in other countries.
Corneal erosions develop in the first and second decade of life and cause ocular discomfort and pain. The erosions recur and vision gradually becomes impaired.
Thiel-Behnke corneal dystrophy appears to be caused by mutation in the TGFBI gene (5q31), like Reis-Bücklers corneal dystrophy. However, there appears to be genetic heterogeneity as another locus has also been identified on chromosome 10 (10q23-q24).
Histological examinations reveal a variable thickness of the corneal epithelium. The epithelial basal lamina and Bowman layer display variable degenerative changes. Irregular subepithelial collagenous tissue is also found.
TBCD is clinically similar to Reis-Bücklers corneal dystrophy (RBCD, see this term), but generally has a less severe course. Tissue examination or molecular genetic analysis can be used to differentiate TBCD and RBCD.
This entity has an autosomal dominant mode of inheritance.
Management and treatment
The pathologic corneal tissue can be excised surgically or with an eximer laser.