Interstitial Keratitis

Tu, Elmer Y.

doi:10.1007/978-3-030-42634-7_328

Cited by 1 publication

(1 citation statement)

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“…The underlying causes of interstitial keratitis fall into 2 categories: infectious or immune-mediated. 10 HSV has typically been viewed as one of the leading cause of stromal keratitis. [11][12][13] CMV, on the other hand, has not been commonly associated with stromal keratitis, but we present 5 cases in which stromal keratitis occurred in the setting of anterior uveitis or with recurrent endotheliitis and in 1 case anterior scleritis.…”

Section: Discussionmentioning

confidence: 99%

Stromal Keratitis Associated With CMV Anterior Uveitis

Pisitpayat,

Mentreddy,

Pekmezci

et al. 2024

Cornea

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Purpose: Human cytomegalovirus (CMV) has commonly been reported as a cause of anterior uveitis and corneal endotheliitis. Unlike its other herpetic family members, herpes simplex virus and varicella zoster virus, involvement of the corneal stroma in CMV is uncommon. In this case series, we describe patients with CMV stromal keratitis. Methods: This was a retrospective chart review of patients seen at a tertiary referral center from 1999 to 2023 with stromal keratitis who tested positive for CMV by directed polymerase chain reaction of aqueous fluid or corneal tissue. Results: This series describes 5 patients, 4 of whom presented with anterior uveitis and stromal keratitis and were confirmed to be positive for CMV through the polymerase chain reaction of aqueous fluid. The fifth patient experienced recurrent corneal graft failures, with the most recent failed graft being positive for CMV based on immunohistochemical stains of the corneal stroma. The average age of patients was 62 years (range 36–80 years). Only 1 patient (20%) exhibited elevated intraocular pressure with stellate keratic precipitates at the initial presentation, whereas 3 other patients (60%) had a known history of glaucoma. Conclusions: Uveitis specialists are well aware of CMV as a cause of recurrent, hypertensive anterior uveitis but should also consider CMV in cases featuring stromal keratitis. The corneal endothelium may serve as a reservoir for both anterior uveitis and development of corneal stromal inflammation as demonstrated by the immunohistopathology exhibited in 1 case.

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