Posters

Bilateral non-luetic interstitial keratitis: a case report

Poster Details

First Author: A.Quintero Palomino SPAIN

Co Author(s):    J. Sandoval Codoni   J. Gonzalez de Gor Crooke                 

Abstract Details

Purpose:

We hereby present a case of bilateral interstitial keratitis in a patient finally diagnosed with Cogan syndrome.

Setting:

The patient is currently followed up in the outpatient Ocular surface and Cornea department of Hospital Universitario Virgen de la Victoria ( Málaga, Spain).

Methods:

Review of the clinical history and additional documentation of the case. Our patient was followed up weekly with a complete ophthalmological evaluation including visual acuity, biomicroscopy, tonometry, fundoscopic analysis and serial photography.

Results:

A 53-year-old male presented with a one-month history of bilateral decreased visual acuity(VA),vertigo and tinnitus after a viral episode a week ago.He did not refer any other medical or ophthalmological background conditions.On examination,VA was 0.6 in his right eye and 0.5 in his left eye.Biomicroscopy showed deep peripheral stromal haze with associated neovascularization not involving the visual axis.The patient was referred to the ENT, finding a sensorineural deafness and resulting in diagnosis of Cogan syndrome.A vasculitic screening was performed and the patient was initiated on oral steroids to avoid irreversible deafness,while a conservative management was suggested for the ocular pathology.

Conclusions:

Interstitial keratitis represents an inflammatory process of the corneal stromae without primary involvement of epithelium/endothelium.Infectious and immune-mediated processes can trigger this inflammation.Even though syphilis was the classical etiology of interstitial keratitis,nowadays it does not represent the most frequent cause in our population.Other infectious diseases and immune-mediated processes,such as Cogan syndrome,need to be taken into account.Although the etiopathogenesis is unknown, immune-related processes play a role in its development. Cogan syndrome represents an exclusion diagnosis being early diagnosis and treatment as well as close follow up essential for these patients.

Financial Disclosure:

None