Keratitis With Mixed Viral-Autoimmune Etiology. Diagnostics, Treatment.
Published 2025 - 43rd Congress of the ESCRS
Reference: PO192 | Type: Case Report | DOI: 10.82333/ehdt-9h10
Authors: Liudmyla Troichenko* 1 , Galina Drozhzhyna 2
1Cornea,The Filatov Institute of Eye Diseases and Tissue Therapy NAMS of Ukraine,Odessa,Ukraine, 2The Filatov Institute of Eye Diseases and Tissue Therapy NAMS of Ukraine,Odessa,Ukraine
Purpose
To present a clinical example of diagnosis and treatment of keratitis with mixed viral-autoimmune etiology
Setting
The study conducted in SI " The Filatov Institute of Eye Diseases and Tissue Therapy NAMS of Ukraine"
Report of case
Patient Sh.31 years old men was admitted to inpatient treatment 2 years ago with subtotal opacification of the cornea with vascularization of both eyes ( BE).
BCVA at OU - 0.01; anamnesis - the patient has been ill since adolescence after a viral illness. Recurrent keratitis (twice a year).
Schirmer test BE - 5-6mm; Norn test -6 sec; decreased corneal sensitivity.
increased IgG antibodies to Herpes virus, cytomegalovirus, nuclear antigen of the Einstein Barr virus, herpes zoster virus. PCR to CMV, HSV, EBV – negative. Antinuclear antibodies IgG - 0.29 (normal); HLA –B27 - not identified. Consultations of dermatologist – diagnosis: Rosacea stage II.
Confirmed diagnosis: Chronic herpetic infection, Rosacea. Severe dry eye desiases. Vascularized corneal opacification. Keratitis of mixed etiology (viral-autoimmune).
Treatment: Anti-inflammatory (nonsteroidal anti-inflammatory drugs and glucocorticoids); antiviral (interferon alpha-2b recombinant, valacyclovir); preservative-free tear substitutes; doxycycline; cyclosporine.
After 1 year of treatment, the patient's conjunctival hyperemia and corneal vascularization decreased. Corneal opacities decreased significantly. BCVA increased by OD to 0.1 and by OS to 0.14. Schirmer's test has increased to 8-10 мм , Norn test- to 9 sek.
After 2 years of observation, the patient's corneal opacity significantly decreased. BCVA increased by OD to 0.12 and by OS to 0.3.
Conclusion/Take home message
Conclusion
It was possible to reduce the signs of the inflammatory process, improve tear production, reduce vascularization and opacification of the cornea, and improve visual acuity in a patient with severe DES, vascularized corneal opacification,
keratitis of mixed etiology (viral-autoimmune) with long-term use of cyclosporine A in complex anti-inflammatory and neurotrophic treatment