Posters

A case of cytomegalovirus keratitis mimicking herpetic keratitis

Poster Details

First Author: M.Mestanoglu TURKEY

Co Author(s): R. Kurt   B. Sonmez                 

Abstract Details

Purpose:

To report a case of sequential, bilateral cytomegalovirus (CMV) stromal keratitis mimicking herpes simplex virus (HSV) keratitis which only responded to  systemic valganciclovir therapy.

Setting:

Bahçeşehir University School of Medicine, Department of Ophthalmology, Istanbul, Turkey

Methods:

A 21-year-old female patient presented with a history of keratitis and corneal scarring in the right eye. She had been treated for herpetic stromal keratitis with topical and systemic acyclovir-valaciclovir therapy without improvement. After having similar symptoms and stromal inflammatory signs in the other eye, an immunoassay analysis was performed; results suggesting a CMV infection.

Results:

Best corrected visual acuities were 0.05 and 0.7 in the right and left eyes, respectively. Slit-lamp examination revealed central scar and lipid deposition in the right cornea with deep active stromal vascularization and surrounding stromal edema. The left eye demonstrated several intrastromal infiltrates with intact corneal epithelium. Corneal sensitivity was normal in both eyes. Medical treatment was switched to oral valganciclovir and topical dexamethasone. Stromal infiltrates in the left eye disappeared within 7 days after the therapy. Best corrected visual acuity increased to 0.2 in the right eye and 1.0 in the left eye.

Conclusions:

CMV is one of the rare causes of stromal keratitis. It can mimic HSV keratitis with its similar slit lamp signs. CMV keratitis should be considered in the differential diagnosis in patients presenting with unilateral or bilateral interstitial keratitis. Systemic valganciclovir therapy combined with topical steroids can be effective in the treatment of CMV stromal keratitis.

Financial Disclosure:

None