Salzmann Nodular Degeneration in an Adolescent Patient: A Clinical Case

Salzmann nodular degeneration (SND) is a rare, non-inflammatory, slowly progressive degenerative corneal disease characterized by the formation of superficial bluish-white nodules measuring 1–3 mm in diameter. Although the condition was first described more than 80 years ago, many aspects of its etiopathogenesis, risk factors, epidemiology, and clinical course remain insufficiently studied. SND typically manifests in the fifth or sixth decade of life, whereas onset in childhood or adolescence is considerably less common and may present diagnostic challenges, particularly in patients with long-standing recurrent epithelial corneal disorders. 

Purpose: to present a clinical case of Salzmann nodular degeneration in an adolescent patient and to analyze the features of its clinical course and management. 

Patient and methods. A clinical case of a 16-year-old female patient with bilateral anterior segment involvement is described. A comprehensive ophthalmologic examination was performed, including assessment of visual acuity, slit-lamp biomicroscopy, keratometry, autorefractometry, and optical coherence tomography. Treatment included superficial keratectomy followed by postoperative medical therapy aimed at controlling inflammatory changes and promoting corneal epithelial recovery, as well as use of a bandage soft contact lens combined with keratoprotective therapy during the postoperative period.

Results. At initial examination, typical SND findings were identified, including subepithelial and superficial stromal nodular opacities with epithelial elevation. The combined surgical and conservative treatment resulted in complete corneal re-epithelialization, reduction in the severity of corneal opacities, improvement in visual acuity, and stabilization of the ocular surface. During a 9-month follow-up period, no signs of disease progression were observed. 

Conclusion. The presented clinical case illustrates a rare manifestation of Salzmann nodular degeneration in the adolescent patients and highlights the importance of timely diagnosis and a comprehensive treatment approach to achieve favorable clinical outcomes and stabilization of visual function.

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