Herpetic Endothelitis In An Isolated And Unilateral Corneal Edema
Published 2024 - 42nd Congress of the ESCRS
Reference: PO703 | Type: Poster | DOI: 10.82333/kty8-a369
Authors: Fatima Zahra Kassimi* 1 , youssef harrar 1 , rihab skiker 1 , fatima zahra Mebrouki 1 , asmae maadane 1 , siham chariba 1 , rachid sekhsoukh 1
1OPHTALMOLOGY,CHU MOHAMMED VI - OUJDA,OUJDA,Morocco
Purpose
The purpose of our présentation is to describe the clinical and imaging aspects of herpetic endothelitis, and remind the importance of evoking this diagnosis in the presence of isolated corneal edema .
Setting
We report the case of a patient hospitalized in the Ophthalmology Department of the CHU Mohammed VI of OUJDA.
Methods
We report the case of a 55 years old patient hospitalized in the Ophthalmology Department of the CHU Mohammed VI of OUJDA.
She consulted for a blurred vision in the left eye without pain or redness .
-The clinical examination revealed in the left eye: visual acuity(VA): couting fingers at 5m,Central corneal edema (peripheric zone was clear)with descemetic folds, some retro-descemetic precipitates(RDP) and some inflammatory cells in the anterior chamber.The Fluorescein was negative,posterior polar cataract .The intraocular pression and the retinal fundus were normal . The right eye was normal .
-Anterior segment Oct showed hyper-reflectivity of the endothelium and Descemet's membrane.The posterior surface is corrugated due to corneal edema.
Results
-The patient received anti-herpetic treatment with topical and subconjunctival corticosteroids 48h after valaciclovir.The evolution was favorable regression of edema VA 07/10.Preventive anti-herpetic treatment was instituted to reduce the risk of recurrence.
-Herpetic endothelitis is characterized by stromal edema with RCP only in the zone of corneal edema without infiltrates.3 forms:linear,disciform,diffuse.Functional signs are generally moderate.The linear form is the most severe with the risk of endothelial destruction if antiviral treatment is not initiated.In the diffuse form, functional signs are more marked and edema is diffuse.
-Corticosteroids can only be introduced once clinical confirmation of antiviral efficacy has been obtained.
Conclusions
-Herpetic endothelitis is one of the diagnostics to be considered in the presence of a unilateral and isolated corneal edema, especially in the absence of epithelial or stromal keratitis.
-The prognosis is generally good for disciform endothelitis if antiviral treatment combined with corticosteroid therapy has been instituted in a timely manner.