J Korean Ophthalmol Soc.  2020 Feb;61(2):205-208. 10.3341/jkos.2020.61.2.205.

Epstein-Barr Virus-related Corneal Endotheliitis Accompanied with Secondary Glaucoma

• Cho YW
• Kang HJ
• Kim GN
• Kim HA
• Chung IY
• Kim SJ

• KMID: 2470744
• DOI: http://doi.org/10.3341/jkos.2020.61.2.205

Abstract

PURPOSE
To report a case of Epstein-Barr virus-related corneal endotheliitis accompanied by secondary glaucoma.
CASE SUMMARY
A 73-year-old male presented with blurred vision in his right eye. In the ophthalmic evaluation, there were dispersed keratic precipitates overlying corneal edema. The anterior chamber showed trace ~1+ graded inflammation and an endothelial density decrease. His best-corrected visual acuity and intraocular pressure in the right eye were 0.2 and 34 mmHg, respectively. Paracentesis was performed on the anterior chamber of the right eye to confirm the diagnosis under the suspicion of corneal endotheliitis with trabeculectomy for the intraocular pressure control. Epstein-Barr virus was confirmed using a multiplex polymerase chain reaction (PCR), and oral and eye drops of Acyclovir were used to treat the patient. There was no evidence of a recurrence over 2 years and his intraocular pressure was 12 mmHg and best-corrected visual acuity was maintained at 0.5.
CONCLUSIONS
A case of Epstein-Barr virus-related corneal endotheliitis was diagnosed using PCR of the aqueous humor. The patient was treated with an oral antiviral agent and eyedrops without a recurrence.

Keyword

Acyclovir; Endotheliitis; Epstein-Barr Virus

MeSH Terms

Acyclovir
Aged
Anterior Chamber
Aqueous Humor
Corneal Edema
Diagnosis
Glaucoma*
Herpesvirus 4, Human
Humans
Inflammation
Intraocular Pressure
Male
Multiplex Polymerase Chain Reaction
Ophthalmic Solutions
Paracentesis
Polymerase Chain Reaction
Recurrence
Trabeculectomy
Visual Acuity
Acyclovir
Ophthalmic Solutions

Figure

• 

  Figure 1 Slit-lamp photograph showed diffuse corneal edema and multiple fine keratic precipitates in right eye.

• 

  Figure 2 Polymerase chain reaction product from assay controls. Sample in lanes is EBV positive. NC = negative control; PC = positive control; IC = initial control; CMV = cytomegalovirus; HSV1 = human simplex virus 1; HSV2 = human simplex virus 2; VZV = varicella zoster virus; EBV = Epstein-Barr virus; HHV6 = Human Herpes virus 6.

• 

  Figure 3 Slit-lamp photograph showed clear cornea and no keratic precipitates in right eye 6 weeks after treatment.

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