Posters

Bilateral neurothrophic keratitis in a patient with San Diego hemoglobinopathy

Poster Details

First Author: B.Giavi GREECE

Co Author(s): K. Andreanos   D. Alexiadou   V. Katsiampoula   G. Kymionis   C. Koutsandrea   K. Droutsas     

Abstract Details

Purpose:

To report bilateral neurotrophic keratitis associated with San Diego hemoglobinopathy.

Setting:

Cornea service of an academic tersiary referral center.

Methods:

A 41- year old man with San Diego hemoglobinopathy was referred due to infectious keratitis of his left eye (OS). Best-corrected visual acuity was 0.9 in the right eye and 1.0 OS. Slit lamp examination revealed a superficial round infiltrate in the paracentral cornea (diameter 1.5mm) and mild hypopyon iritis OS. A severe superficial punctate epitheliopathy as well as fine endothelial precipitates were detectable in the central cornea accompanied by marked corneal hypesthesia of both eyes.The infectious keratitis was treated with topical antibiotics. However,as the epitheliopathy and endothelial precipitates persisted, a workup for potential causes of neurotrophic keratitis was performed.

Results:

Confocal microscopy revealed a diminished and at some areas absent subepithelial neural plexus as well as signs of keratocyte activationof both corneas. An extensive workup for iritis as well as the neurological workup and imaging were negative for intracranial pathology. Real-time polymerase chain reaction of the aqueous humour for herpes viridae was also negative. Punctate epitheliopathy regressed significantly after 3 months of treatment with topical cyclosporine 0.1% twice daily and lubrication with preservative-free artificial tears containing citicoline.

Conclusions:

Herein, a case of bilateral neurotrophic keratitis in an otherwise healthy man is reported, indicating a potential association of the two entities.

Financial Disclosure:

None