Fig. 1

Imaging features of lipid keratopathy in case 1 were consistent with histopathological observations. (A) Clinical progression of case 1, a 4-year-old, male castrated, Cavalier King Charles Spaniel. At initial presentation (a), there was subtle crystalline opacity in the right eye (OD) and dense crystalline opacity with nasal perilimbal infiltration in the left eye (OS). With topical anti-inflammatory treatment, the perilimbal infiltration was resolved OS, but a similar perilimbal infiltration developed in the nasal cornea OD (b). At 4 months after initial presentation and with anti-inflammatory therapy (c), the crystalline opacity was enlarged and more distributed in the cornea OU, but the perilimbal infiltration was resolved OD. (B) Fourier-domain optical coherence tomography (FD-OCT) demonstrated hyperreflective dots or lines along the stromal collagen lamellae from subepithelium to mid stroma in both eyes; these appeared to coalesce into geographic areas of hyperreflectivity (*). Posterior shadowing prevented the view of posterior cornea where the deposits were dense. (C) In vivo confocal microscopy (IVCM) identified highly reflective needle-like structures in both eyes. (D) Oil-red O staining confirmed the presence of lipid deposition which stained red (arrows) in the affected cornea OS