This is another example of a Khoudadoust line (endothelial rejection) in a patient with a long-standing penetrating keratoplasty. A slitlamp photograph using sclerotic scatter technique demonstrates inferior to superior progression of endothelial rejection with keratitic precipitates at the leading edge. The overlying stroma is hazy and edematous with evident Descemet's folds due to acute endothelial dysfunction. The uninvolved superior corneal stroma is compact and clear
A 24-year-old female presented with acute allograft rejection after self-discontinuing her topical steroid drops after penetrating keratoplasty for keratoconus.
The figure shows corneal decompensation with inferior corneal edema and haze and a faint horizontal endothelial linear opacitiy which is more distinct with sclerotic scatter lighting. This opacity is a rejection line consistent of white blood cells on the endothlium and is also known as a Khodadoust line. This sign represents graft rejection and if left untreated will march across the graft.
56-year-old female status post full-thickness corneal transplant presented to our clinic with signs of endothelial cell rejection. This can be seen clinically as a Khodadoust line (arrow), which represents white blood cells on the endothelium. This "rejection line" usually begins in one area of the cornea and marches across the endothelium over time. In this particular patient, the rejection line began inferonasally and has now migrated all the way to the superior cornea. One can see that the cornea inferior to the line is much more edematous and hazy as compared with the cornea superior to the Khodadoust line, where the cornea is still relatively clear and the endothelium relatively unaffected. The slit beam is shown to illustrate that this line is indeed on the corneal endothelium.
A 21-year-old female presented with acute worsening of vision after full-thickness corneal transplant in the right eye. Her medical history was pertinent for recent influenza vaccination. On exam, there were signs of endothelial rejection with keratic precipitates in a linear fashion on the endothelium, commonly known as a Khodadoust line after Iranian ophthalmologist, Dr. Ali Khodadoust. Superior progression of endothelial rejection with keratitic precipitates at the leading edge.
Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Address
University of IowaLegal
Related Links
