DNA of cytomegalovirus detected by PCR in aqueous of patient with corneal endotheliitis after penetrating keratoplasty

TitleDNA of cytomegalovirus detected by PCR in aqueous of patient with corneal endotheliitis after penetrating keratoplasty
Publication TypeJournal Article
Year of Publication2007
AuthorsSuzuki T, Hara Y, Uno T, Ohashi Y
JournalCornea
Volume26
Issue3
Pagination370 - 2
Date PublishedApr
ISSN0277-3740 (Print) 0277-3740 (Linking)
Accession Number17413969
Keywords*Keratoplasty, Penetrating, Aged, Antiviral Agents / therapeutic use, Aqueous Humor / *virology, Cytomegalovirus / *genetics / isolation & purification, Cytomegalovirus Infections / diagnosis / drug therapy / *virology, DNA, Viral / *analysis, Endothelium, Corneal / *virology, Eye Infections, Viral / diagnosis / drug therapy / *virology, Ganciclovir / therapeutic use, Humans, Keratitis / diagnosis / drug therapy / *virology, Male, Polymerase Chain Reaction
Abstract

PURPOSE: Corneal endotheliitis often leads to severe endothelial dysfunction and can be caused by herpes simplex virus (HSV), varicella zoster virus (VZV), and other viruses (eg, the mumps virus). We report a case of corneal endotheliitis caused by cytomegalovirus (CMV) that developed after a penetrating keratoplasty. METHODS: A complete ophthalmologic examination was performed on a patient with corneal endotheliitis that developed after a penetrating keratoplasty. To determine the cause of the endotheliitis, polymerase chain reaction (PCR) was used to amplify the DNA of HSV, VZV, and CMV in samples of the aqueous humor. RESULTS: Slit-lamp biomicroscopy showed a moderate stromal edema in the upper temporal part of the transplanted cornea along with keratic precipitates (KPs) arranged in a coin-shaped pattern. Repeated treatments with steroids and acyclovir were only temporarily successful. PCR detected the DNA of CMV in an aqueous sample, and the treatment was switched to topical and systemic application of ganciclovir. This resulted in the disappearance of the KPs and resolution of the stromal edema within 2 weeks. CONCLUSIONS: From the PCR results and the favorable response to ganciclovir, the corneal endotheliitis was most likely caused by cytomegalovirus in this case.

URLinternal-pdf://Suzuki - CMV-4237185793/Suzuki - CMV.pdf
DOI10.1097/ICO.0b013e31802d82fa 00003226-200704000-00024 [pii]
Notify Library Reference ID1503

Related Incidents