Posters

Interstitial keratitis: a case report and a literature review

Poster Details

First Author: R.Azahrai MOROCCO

Co Author(s): M. Atmani   M. Achergui   M. Smiri   S. Chariba   A. Maadane   R. Sekhsoukh     

Abstract Details

Purpose:

Interstitial keratitis is a non-ulcerative and non-suppurative, more or less vascularised inflammation of the corneal stroma. Corneal lesions result from a response of the host to bacterial, viral, parasitary antigens or auto-immune antigenes without active corneal infection. The evolution of the disease consists of two phases, acute and cicatricial.  They  require an early diagnosis with an etiologic assessment and an adequate treatment to optimise the visual prognosis and to avoid other complications . Amongst the principal etiologies, there are bacterial infections (syphilis), viral diseases (40%) ; 33% are idiopathic. The Cogan syndrome represents less than 1% of cases.

Setting:

ophtalmology service ;CHU mohammed VI OUJDA

Methods:

A 7-year-old girl consults for a painful red eye with reduced visual acuity in the left eye since one month. She is without antecedent of ophthalmic disease. The left eye examination measured the visual acuity of finger movements. Biomicroscopy showed  the reactive conjunctival hyperemia, interstitial corneal infiltrates , diffuse stromal oedema ,inferior corneal neovascularization associated to corneal hypoesthesia , the rest of the examination is inaccessible ,Ultrasonography revealed applied retina . Examination of the Adelphe eye: is without particularity ;

Results:

A biological assessment was requested: - Inflammatory assessment, ANCA, TPHA-VDRL, BK  and IDR, borreliosis serology: negative - Serology VZV, EBV, HSV: IgG (+), IgM (-) Given the results of assessments and corneal hypoesthesia: interstitial viral keratitis has been retained ++  The patient was treated with  an antiviral treatment for 21 days with  corticosteroids after 48 hours of traitement. The evolution was marked by the improvement of visual acuity  to 1//10 and disappearance of the stromal infiltration, with persistence of a central corneal  opacity.

Conclusions:

Interstitial keratitis results from an immune response to foreign antigens or an autoimmune response without active infection of the cornea. Biomicroscopy found  lymphocyte infiltration with stromal edema. More than 40% of cases of interstitial keratitis are of viral origin. The most frequently implicated viruses are Herpes simplex virus  in 71.4% of cases.The diagnosis is based on clinical and biological arguments (herpes serology). In our case , given the frequency of virosis in interstitial keratitis, our patient was treated with antiviral associated to  corticosteroid with a very good functional and anatomical evolution

Financial Disclosure:

None