Distinctive Wessely immune ring in keratitis-a chameleon

Ein Wessely-Immunring kann bei verschiedenen kornealen Infektionen sowie bei nichtinfektiöser Ätiologie auftreten und differenzialdiagnostisch wegweisend, aber auch irreführend sein. Eine definitive Diagnosestellung kann nur in Gesamtschau der klinischen und mikrobiologischen Befunde erfolgen. Differenzialdiagnostische Überlegungen und Therapiestrategien werden im Kontext der Kasuistik eines 31 Jahre alten Kontaktlinsenträgers mit diffuser Endotheldekompensation bei fokalem mittelperipherem Infiltrat mit Wessely-Immunring exemplarisch erörtert und kritisch reflektiert.A Wessely immune ring can be found in various corneal infections as well as in non-infectious processes. Its appearance can aid in the differential diagnosis but can also be misleading. A definitive diagnosis can only be reached when all clinical and microbiological findings are taken into consideration. This article discusses and critically reflects on the differential diagnostic considerations and treatment strategies in the context of a case report on a 31-year-old patient with contact lenses and diffuse endothelial decompensation with a focal, mid-peripheral infiltrate and a Wessely immune ring

Pathophysiology of aniridia-associated keratopathy: Developmental aspects and unanswered questions

Aniridia, a rare congenital disease, is often characterized by a progressive, pronounced limbal insufficiency and ocular surface pathology termed aniridia-associated keratopathy (AAK). Due to the characteristics of AAK and its bilateral nature, clinical management is challenging and complicated by the multiple coexisting ocular and systemic morbidities in aniridia. Although it is primarily assumed that AAK originates from a congenital limbal stem cell deficiency, in recent years AAK and its pathogenesis has been questioned in the light of new evidence and a refined understanding of ocular development and the biology of limbal stem cells (LSCs) and their niche. Here, by consolidating and comparing the latest clinical and preclinical evidence, we discuss key unanswered questions regarding ocular developmental aspects crucial to AAK. We also highlight hypotheses on the potential role of LSCs and the ocular surface microenvironment in AAK. The insights thus gained lead to a greater appreciation for the role of developmental and cellular processes in the emergence of AAK. They also highlight areas for future research to enable a deeper understanding of aniridia, and thereby the potential to develop new treatments for this rare but blinding ocular surface disease