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Post-varicella disciform keratitis: case report

Poster Details


First Author: N.Velikova-Pavlova BULGARIA

Co Author(s): B. Kutchoukov   A. Yaneva                 

Abstract Details

Purpose:

The purpose of this study is to report a rare condition of post-varicella disciform keratitis in a 4-year-old child, related to high serum antibody titers (IgM and IgG) two months after the skin lesions.Rapid response to topical steroids, topical and oral antivirals was observed in 2 weeks of treatment. Total resolution of the disciform stromal keratitis occurred on the 12-th week.

Setting:

University Hospital “Queen Yoanna-ISUL”,Sofia,Bulgaria

Methods:

Ophthalmological examination was performed, incl. external view, visual acuity, tonometry, slit-lamp examination, fundoscopy, fluorescein-stain test, pupillary light reaction, OCT of anterior and posterior eye segment, serologic analysis.

Results:

It is a case report of a 4-year-old girl having history of skin rash 2 months before disciform keratitis was diagnosed.A slit-lamp examination revealed central localized area of disciform stromal edema with folds of Descemet’s membrane, without keratic precipitates of the right eye.BCVA of the right eye was 20/120 (0,1), BCVA of the left eye was 20/20 (1,0) (Allen pictures).IOP for both eyes was normal. The specific serum IgM and IgG antibody against the VZV were: 1,94 UI/L (<0,8 negative; >1,1 positive) and 5835 UI/L (<0,6 negative; >0,9 positive).The treatment was:- Fluorometholone 1mg/ml qid;- Cyclopentolate 1% 3 tip;- Acyclovir ophth. ointment 5 times a day;- Oral Acyclovir for 14 days (80mg/kg daily)At the 10-th day of the treatment the stromal edema showed reduction and the dose of topical fluorometholone was diminished. At the 6-th week the cornea was clear without scarring and neovascularization.

Conclusions:

Based on the clinical picture and a review of literature we believe that this is a rare case of varicella corneal complication, that may occur and recur several weeks or months after the primary skin lesions.

Financial Disclosure:

None

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