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Atypical Vortex Pattern of Corneal Deposits in Granular Corneal Dystrophy

Purpose To report the appearance of an unusual vortex pattern of corneal deposits in two patients with the R555W mutation in the transforming growth factor &bgr;–induced gene (TGFB1) associated with granular corneal dystrophy. Methods DNA from affected patients and unaffected relatives was isolated from buccal swabs, and TGFB1 mutation screening was performed. Results The proband and an affected daughter demonstrated rays of deposits emanating from a point in the inferior cornea of each eye in a “sea fan” or vortex pattern. Screening all 17 exons of TGFB1 in the proband identified a single missense mutation (C1710T) in exon 12, consistent with the diagnosis of granular corneal dystrophy. The identical mutation was identified in the affected daughter. Conclusions In spite of the strict phenotype–genotype correlation reported for the TGFB1-associated corneal dystrophies, atypical clinical findings may be produced by previously identified, conserved mutations.