COULD HERPETIC KERATITIS CONSIDERED AS AN AETIOLOGY IN RECCURENT CORNEAL EROSIONS SYNDROME ?
Published 2023
- 27th ESCRS Winter Meeting
Reference: P208
| Type: Case Report (Cornea Day)
| DOI:
10.82333/rysv-8k24
Authors:
Imad Messafi* 1
, FatimaZahra Mabrouki 1
, Rokia Azahrai 1
, Mohammed Taous 1
, Siham Chariba 1
, Asmae Maadane 1
, Rachid Sekhsoukh 1
1Ophthalmology,Mohammed VI University Hospital,Oujda,Morocco
Purpose
Corneal epithelial detachment is often associated with recurrent corneal erosions and bullous keratopathy.The clinical picture combines redness, pain and tearing. Often in patients with a history of trauma, surgery, or corneal dystrophies. We report an atypical case of recurrent epithelial basal membrane detachment following a herpetic infection and we would like to discuss the therapeutic possibilities for our patient.
Setting
Ophthalmology departement, Mohammed VI university Hospital, oujda , Morocco.
we report a case of a patient presneting a reccurent epithelial detachement following a herpetic keratitis.
Report of case
55-year-old patient, recurrent episodes of herpetic keratitis for 5 months in OS: VA at , with diffuse erosions, corneal edema, treated with valaciolovir 2g*3/d with surface treatment => good evolution but recurrence when treatment ended . second cure with good evolution and maintain a prophylactic dose. 2 weeks later, the patient presents for the recurrence of ocular pain, associated with tearing and ocular redness visual acuity at 0.5 conjunctival hyperemia punctate Corneal erosions Presence of an epithelial bulla below ( confirmed by anterior segment oct shown below) , no descemetocele, no clear signs of endotheliitis = maintain the same treatment and use of a therapeutic lens = Good evolution .A new reccurence was noted 2 weeks after taking off the lens : a micropuncture and in fine a phootherapeutic keratectomy were considered but the patient refused at the start , so we kept a prophylactic antiviral dose, renforced the surface treatement and put a bandage lens . No reccurence was noticed at 6 months. the patient is informed and is accepting an intervention in case of reccurence.
Conclusion / Take home message
Our case opens the discussion on the involvement of viruses ( few cases in litterature) in dystrophy of the epithelial basal membrane and in the syndrome of recurrent corneal erosionsThe treatment .includes several means, but which remains poorly codified given the insufficiency of the studies. We aim trhourgh this case to bring a new aetiologic theory and discuss the management of corneal erosions through the AAO recommandations.