Open AccessCytomegalovirus Endotheliitis After Penetrating Keratoplasty
Author(s) -
Tuna Çelik Büyüktepe,
F Nilüfer Yalçındağ
Publication year - 2020
Publication title -
türk oftalmoloji dergisi
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.654
H-Index - 10
eISSN - 2147-2661
pISSN - 1300-0659
DOI - 10.4274/tjo.galenos.2020.47568
Subject(s) - medicine , valganciclovir , cytomegalovirus , corneal endothelium , ophthalmology , uveitis , corneal transplant , cornea , corneal transplantation , ganciclovir , immunology , human cytomegalovirus , herpesviridae , virus , viral disease
Cytomegalovirus (CMV)-related corneal endotheliitis is an inflammation of the corneal endothelium caused by CMV. It may occur de novo or after ocular surgery in otherwise healthy individuals. In patients who have undergone keratoplasty, the differential diagnosis of viral endotheliitis and immune-related graft rejection is challenging due to the similar clinical findings. Here we report a patient who underwent penetrating keratoplasty and was using local and systemic immunosuppressive agents due to previous history of graft rejection. At postoperative year 4, ophthalmologic examination revealed localized corneal edema, coin-shaped keratic precipitates, and increased intraocular pressure, consistent with viral endotheliitis. Polymerase chain reaction revealed CMV-DNA amplification in the aqueous humor sample. Valganciclovir treatment was started and the symptoms improved in 2 months. It should be kept in mind that local or systemic immunosuppressants used after keratoplasty may trigger CMV reactivation. Anti-CMV treatment should be initiated immediately in patients with coin-shaped keratic precipitates.