Symptoma

Endotheliitis

Of the 122 DMEK surgeries in the series, only 4 patients were diagnosed with CMV corneal endotheliitis; presentation occurred 5 to 15 weeks after DMEK. Outcomes All 4 cases presented with keratic precipitates and anterior uveitis. [aao.org]

Key Method The patient had no documented positive history of ocular surgery and no abnormal findings were present in the fellow eye. [semanticscholar.org]

Discussion Cornea graft rejection and viral infection can present with very similar clinical presentation, particularly in cases with multiple history of penetrating keratoplasty. [egms.de]

[…] is unusual distribution of keratic precipitates (KP) behind zones of edema.2 Depending on the presentation, however, KP may or may not be visible. [reviewofcontactlenses.com]

Results showed that genomic DNA of HHV-6 was present. The 23 other pathogens, e.g., HSV type 1 and 2, VZV, EBV, CMV, HHV-7, HHV-8, bacterial 16s ribosomal RNA (rRNA), and fungal 28s rRNA were however not present. [bmcophthalmol.biomedcentral.com]

  • Localized Edema

    The anterior chamber of rabbits was sensitized with inactivated virus, thereafter live virus were inoculated and local edema associated to endothelial precipitates and mild anterior chamber reaction were observed. [scielo.br]

    (C) Localized edema on both the donor and recipient cornea (white arrow). KPs keratic precipitates. On suspicion of viral endotheliitis, the patient was sent to the operating room and the aqueous humor was sampled for viral PCR analysis. [journals.lww.com]

  • Falling

    Herpetic KP typically fall outside of this triangle. In diffuse endotheliitis, the distribution of KP is widely spread across the corneal endothelium. [reviewofcontactlenses.com]

  • Corneal Edema

    Increased corneal edema and descemet's membrane (DM) detachment occurred on postoperative day 3 and 5, respectively. One week after surgery, active keratic precipitates (KPs) appeared. [miami.pure.elsevier.com]

    (Bottom) Diffuse corneal edema and endothelial alterations detected by IVCM. [iovs.arvojournals.org]

    Here, the diagnostic key is the corneal edema. [reviewofcontactlenses.com]

    Localized corneal edemas were evident on both the donor and recipient corneas (Fig. 1C). The edema was bordered by the linear KPs. Figure 1: Linear KPs and corneal edema in a post-keratoplasty cornea of the right eye. [journals.lww.com]

    Seminars in Ophthalmology Jun 28, 2008 Abstract Corneal endotheliitis is an intriguing clinical entity manifested by corneal edema, keratic precipitates, and mild anterior chamber reaction, and can be defined as a spectrum of the disorder in which the [meta.org]

  • Corneal Opacity

    Case summary A 45-year-old male with a history of re-penetrating keratoplasty due to corneal opacity and graft failure after previous penetrating keratoplasty of his right eye in April 2014, visited our clinic for intermittent injection of the right eye [synapse.koreamed.org]

    Deep anterior lamellar keratoplasty in herpes simplex corneal opacities. Cornea 2010;29(1):60-4. Wang J, Zhao G, Xie L, et al. Therapeutic effect of deep anterior lamellar keratoplasty for active or quiescent herpetic stromal keratitis. [eyewiki.aao.org]

  • Ciliary Injection

    Corneal graft rejection is similar to corneal endotheliitis in symptoms and clinical features such as ciliary injection, decreased visual acuity, corneal edema or anterior chamber reaction. [synapse.koreamed.org]

    Slitlamp examination showed severe corneal edema, ciliary injection, and keratic precipitates (Figure 1). The fundus, optic nerve, and fellow eye were normal. [jamanetwork.com]

  • Eye Pain

    Twenty days after the last injection, the patient presented with a 1-week duration of left eye pain. [bmcophthalmol.biomedcentral.com]

Post-operative prophylactic systemic valganciclovir treatment was instituted and switched to topical valganciclovir treatment when aqueous samples were negative for CMV. [joii-journal.springeropen.com]

The treatment plan differs according to the etiology. [journals.lww.com]

Medical treatment for CMV endotheliitis In Japan, ganciclovir is available for the treatment of intravenous infusion, and valganciclovir hydrochloride tablets for CMV infection. [bjo.bmj.com]

The treatment of CMV-related corneal endotheliitis should cover both infectious and inflammatory components. Systemic antiviral treatment with topical corticosteroids should be started. [egms.de]

Best treatment and risk of recurrence Oral valganciclovir 900 mg twice a day for six weeks followed by 900 mg every morning for six weeks is an effective treatment for patients with CMV endotheliitis, Dr. Chee said. [eyeworld.org]

This exudative-AMD has a peculiar clinical history and prognosis. RAP accounts from 8% to 22% of newly diagnosed cases among patients previously diagnosed as exudative AMD, and up to 25% of the occult or minimally classic CNV. [read.qxmd.com]

Presentation of Acanthamoeba Keratitis. 61 Hsu CW...Hsiao CH 31219868 2019 12 A Review of Corneal Endotheliitis and Endotheliopathy: Differential Diagnosis, Evaluation, and Treatment. 61 Moshirfar M...Hoopes PC 30859513 2019 13 Therapeutic Challenges and Prognosis [malacards.org]

"CMV endotheliitis appears to carry a worse prognosis than other forms of endotheliitis, including HSV, with a higher rate of recurrence and a higher risk of graft failure," he said. PCR is often the simplest and surest way to tell them apart, Dr. [eyeworld.org]

[…] no previous report of corneal endotheliitis caused by coxsackievirus A24 (CA24), whereas CA24 is known to be a common causative agent of acute hemorrhagic conjunctivitis (AHC).7 Thus, we had not been made aware of the clinical course, treatment, or prognosis [docksci.com]

Such cases are diagnosed as ‘idiopathic corneal endotheliitis’,3 and their prognosis is poor due to the progressive destruction of corneal endothelium that is resistant to antiviral medication. [bjo.bmj.com]

The disease etiology c...read more Mentioned in this Paper Keratitis Virus Diseases Simplexvirus Topical form corticosteroids Neonatal Herpes Anterior Chamber of Eye Structure Fuchs Endothelial Dystrophy Corneal Edema Herpes Zoster Ophthalmicus Etiology [meta.org]

The disease etiology consists of accumulating evidence of various viral infections including herpes simplex virus, varicella zoster virus, and cytomegalovirus. [ncbi.nlm.nih.gov]

[…] of infectious interstitial keratitis, such as other viruses (Varicella zoster virus, Epstein-Barr virus), bacteria (syphilis, lyme), fungus, and Acanthamoeba, as well as immune-mediated etiologies, including sarcoidosis and Cogan syndrome. [eyewiki.aao.org]

The epidemiology of HSV endotheliitis is less clear at least in part because many publications include disciform HSV endotheliitis as a form of HSK. [eyewiki.aao.org]

Intraocular pressure may be elevated secondary to trabeculitis. [14] Pathophysiology The pathophysiology of HSK is complex and remains incompletely understood. [eyewiki.aao.org]

Therefore unnecessary treatment resulting from misdiagnosis in these patients can be prevented. Early recognition and treatment of this condition is important to prevent permanent endothelial cell loss and corneal decompensation. [egms.de]

Topical ganciclovir was used to control and prevent the reactivation of CMV without systemic application and their clinical courses were presented after this treatment modality. [clinicaltrials.gov]

A potentially useful mechanism of therapy, therefore, involves inhibiting viral reactivation to prevent recurrent corneal inflammation. [eyewiki.aao.org]