A Case of Endothelial Keratitis Associated with Immunosuppressant in Kaposi's Varicelliform Eruption.

Kang, Yong Koo; Kim, Myung Jun; Kim, Hong Kyun

doi:2016.57.10.1640

J Korean Ophthalmol Soc > Volume 57(10); 2016 > Article

Case Report

Journal of the Korean Ophthalmological Society 2016;57(10):1640-1644.
DOI: https://doi.org/10.3341/jkos.2016.57.10.1640 Published online October 15, 2016.

A Case of Endothelial Keratitis Associated with Immunosuppressant in Kaposi's Varicelliform Eruption.

Yong Koo Kang, Myung Jun Kim, Hong Kyun Kim

Department of Ophthalmology, Kyungpook National University School of Medicine, Daegu, Korea. okeye@knu.ac.kr

카포시 수두양 환자에서 면역억제제 사용에 의해 이차적으로 발생한 내피각막염 1예

강용구⋅김명준⋅김홍균

경북대학교 의학전문대학원 안과학교실

Abstract

PURPOSE
To report a case of endothelial keratitis occurred after reactivation of herpes simplex virus following immunosuppressant therapy for Kaposi's varicelliform eruption. CASE SUMMARY: A 23-year-old female was referred for ocular pain and blurred vision. She had atopic dermatitis and was diagnosed with Kaposi's varicelliform eruption on her face after using an immunosuppressant. Slit lamp examination revealed central corneal edema in the right eye. She was initially diagnosed with contact lens-induced keratitis. Subsequently, the contact lens was removed and topical antiviral agent used for prevention of ocular involvement. Four days after treatment, Wesseley immune ring of deep stromal haze and cells in the anterior chamber were present. She was diagnosed with endothelial keratitis caused by reactivation of herpes simplex virus after using an immunosuppressant. Topical steroid, hypertonic saline eye drops and cycloplegic eye drops were added to the treatment for the progression of endothelial keratitis. Corneal edema was decreased 2 weeks after treatment and anterior chamber cells decreased 1 month after treatment. There was no recurrence during the follow-up period. CONCLUSIONS: Patients diagnosed with Kaposi's varicelliform eruption after using immunosuppressants should have an ophthalmic examination to confirm ocular involvement; use of appropriate eye drops is necessary for the treatment of corneal involvement.

Key Words: Atopic dermatitis;Cornea edema;Endothelial keratitis;Herpes simplex virus;Kaposi's varicelliform eruption