Cytomegalovirus Endotheliitis After Penetrating Keratoplasty. 2020

Tuna Çelik Büyüktepe, and Nilüfer Yalçındağ
Dr. Nafiz Körez Sincan State Hospital, Clinic of Ophthalmology, Ankara, Turkey.

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.

UI MeSH Term Description Entries
D007634 Keratitis Inflammation of the cornea. Keratitides
D008297 Male Males
D003586 Cytomegalovirus Infections Infection with CYTOMEGALOVIRUS, characterized by enlarged cells bearing intranuclear inclusions. Infection may be in almost any organ, but the salivary glands are the most common site in children, as are the lungs in adults. CMV Inclusion,CMV Inclusions,Congenital CMV Infection,Congenital Cytomegalovirus Infection,Cytomegalic Inclusion Disease,Cytomegalovirus Colitis,Cytomegalovirus Inclusion,Cytomegalovirus Inclusion Disease,Cytomegalovirus Inclusions,Inclusion Disease,Perinatal CMV Infection,Perinatal Cytomegalovirus Infection,Renal Tubular Cytomegalovirus Inclusion,Renal Tubular Cytomegalovirus Inclusions,Salivary Gland Virus Disease,Severe Cytomegalovirus Infection,Severe Cytomegalovirus Infections,Infections, Cytomegalovirus,CMV Infection, Congenital,CMV Infection, Perinatal,Colitis, Cytomegalovirus,Congenital CMV Infections,Congenital Cytomegalovirus Infections,Cytomegalic Inclusion Diseases,Cytomegalovirus Colitides,Cytomegalovirus Inclusion Diseases,Cytomegalovirus Infection,Cytomegalovirus Infection, Congenital,Cytomegalovirus Infection, Perinatal,Cytomegalovirus Infection, Severe,Cytomegalovirus Infections, Severe,Disease, Cytomegalic Inclusion,Disease, Cytomegalovirus Inclusion,Diseases, Cytomegalovirus Inclusion,Inclusion Disease, Cytomegalic,Inclusion Disease, Cytomegalovirus,Inclusion Diseases,Inclusion Diseases, Cytomegalovirus,Inclusion, CMV,Inclusion, Cytomegalovirus,Infection, Congenital CMV,Infection, Congenital Cytomegalovirus,Infection, Cytomegalovirus,Infection, Perinatal CMV,Infection, Perinatal Cytomegalovirus,Infection, Severe Cytomegalovirus,Perinatal CMV Infections,Perinatal Cytomegalovirus Infections
D003587 Cytomegalovirus A genus of the family HERPESVIRIDAE, subfamily BETAHERPESVIRINAE, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. Herpesvirus 5, Human,Human Herpesvirus 5,Salivary Gland Viruses,HHV 5,Herpesvirus 5 (beta), Human,Cytomegaloviruses,Salivary Gland Virus,Virus, Salivary Gland,Viruses, Salivary Gland
D004279 DNA, Viral Deoxyribonucleic acid that makes up the genetic material of viruses. Viral DNA
D004728 Endothelium, Corneal Single layer of large flattened cells covering the surface of the cornea. Anterior Chamber Epithelium,Corneal Endothelium,Endothelium, Anterior Chamber,Epithelium, Anterior Chamber,Anterior Chamber Endothelium
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013530 Surgical Wound Infection Infection occurring at the site of a surgical incision. Postoperative Wound Infection,Infection, Postoperative Wound,Infection, Surgical Wound,Surgical Site Infection,Wound Infection, Postoperative,Wound Infection, Surgical,Infection, Surgical Site,Infections, Postoperative Wound,Infections, Surgical Site,Infections, Surgical Wound,Postoperative Wound Infections,Surgical Site Infections,Surgical Wound Infections,Wound Infections, Postoperative,Wound Infections, Surgical
D015828 Eye Infections, Viral Infections of the eye caused by minute intracellular agents. These infections may lead to severe inflammation in various parts of the eye - conjunctiva, iris, eyelids, etc. Several viruses have been identified as the causative agents. Among these are Herpesvirus, Adenovirus, Poxvirus, and Myxovirus. Ocular Infections, Viral,Viral Eye Infections,Eye Infection, Viral,Infection, Viral Eye,Infection, Viral Ocular,Infections, Viral Eye,Infections, Viral Ocular,Ocular Infection, Viral,Viral Eye Infection,Viral Ocular Infection,Viral Ocular Infections

Related Publications

Tuna Çelik Büyüktepe, and Nilüfer Yalçındağ
May 2022, Cornea,
Tuna Çelik Büyüktepe, and Nilüfer Yalçındağ
January 2010, European journal of ophthalmology,
Tuna Çelik Büyüktepe, and Nilüfer Yalçındağ
January 2013, Clinical & experimental ophthalmology,
Tuna Çelik Büyüktepe, and Nilüfer Yalçındağ
April 2019, Cornea,
Tuna Çelik Büyüktepe, and Nilüfer Yalçındağ
February 2012, The British journal of ophthalmology,
Tuna Çelik Büyüktepe, and Nilüfer Yalçındağ
November 1995, Cornea,
Tuna Çelik Büyüktepe, and Nilüfer Yalçındağ
October 2019, Cornea,
Tuna Çelik Büyüktepe, and Nilüfer Yalçındağ
April 2009, Ophthalmology,
Copied contents to your clipboard!