Ascher Ring

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Disease Entity

Disease

Only a handful of cases have been reported on Ascher ring. It was first described by Dr Ascher in Germany in 1964.

Etiology

Initially, these opacification were believed to be a result of an immunologic reaction as some patients with this entity had ocular history of unilateral idiopathic iritis. However, newer considerations suggest that the opacities are extracellular material likely deposited along a centripetal gradient.

Diagnosis

Examination

On slit lamp examination, intrastromal (of varying depths) mid-peripheral symmetric bilateral corneal rings are observed. There are no associated inheritance patterns or systemic pathologies.

Imaging

Corneal stromal opacification is visualized on OCT. Confocal microscopy shows reflective extracellular deposits.

Management

Prognosis

The prognosis is very good for Ascher ring.

References

  1. Ascher, K. An Unusual Corneal Ring. Ber Zusammenkunft Dtsch Ophthalmol Ges. 1964; 65: 44-46.
  2. Reiger, G. Primare, einseitige, ringförmige Trübung der Hornhaut. Fortschr Ophthalmol. 1987; 84: 242-244.
  3. Rohrbach, J., Kleiser, N., Kaufmann-Fechner, J., Lish, W. Corneal ring opacity (Ascher ring)- a case report. Klin Monbl Augenheilkd. 2001; 218(4): 276-278.
  4. Silvestri, A., Boisjoly, H. Bilateral Corneal Ring Opacity of Unknown Origin. Cornea. 2003; 22(1): 86-87.
  5. Moshirfar, M. Corneal Surgical Problem. J Cataract Refract Surg. 2015; 41: 895-896.
  6. Bron, A. Peripheral ring opacity of the cornea. Brit J Ophthal. 1969; 53:270-273.
  7. Bopp, S., Laqua, H. Corneal Ascher ring. A ring-shaped stromal corneal opacity. Klin Monbl Augenheilkd. 1991; 198(3): 201-204.
  8. Nguyen, D., Quah, S., Kumar, N., et al. In-vivo scanning of Ascher intrastromal corneal ring opacity. Brit J Ophthal. 2007; 1710-1711.
  9. Melles, G., de Sera, J., Eggink, C., et al. Bilateral anterior stromal ring opacity of the cornea. B J Ophthal. 1998; 82: 522-525.
  10. Caroline, P., Melles, G. Two Cases of Bilateral, Stromal Ring Opacity of the Cornea. Cornea. 2001; 20 (2): 237-238.
  11. Almeida, R., Ruao, M., Almeida, I., et al. Bilateral ring-shaped corneal opacity: case report and review of the literature. The Pan-American Journal of Ophthalmology. 2016; 15: 61-62.
  12. Khan JC, Shuttleworth GN. Annular granular corneal opacity: a rare corneal stromal dystrophy or degeneration? Br J Ophthalmol. 2000;84(10):1205-6.