1/14. Bilateral deep keratitis caused by systemic lupus erythematosus.We report the optical and ultrasonic biomicroscopy and confocal microscopy findings in bilateral stromal keratitis (keratoendotheliitis), a rare ocular manifestation of systemic lupus erythematosus (SLE). Examination revealed deposits with polyrefringent crystals. Topical corticosteroid produced regression of the corneal edema, but there was an increase in corneal opacity. Ultrasound biomicroscopy images confirmed the deep location of the corneal opacities, and confocal microscopy showed a disruption of the corneal stroma and crystal-like bodies.- - - - - - - - - - ranking = 1keywords = corneal edema (Clic here for more details about this article) |
2/14. Mumps-induced corneal endotheliitis.OBJECTIVE: To report two cases of corneal endotheliitis following mumps parotitis. methods: Observational case reports of two patients presenting with sudden unilateral diminution of vision while they were in the resolution phase of mumps parotitis. RESULTS: Central corneal edema with no associated epithelial involvement or iridocyclitis was confirmed on slit-lamp biomicroscopy. Specular microscopy confirmed an increased corneal thickness with corneal endothelial abnormalities. The diagnosis of mumps virus infection was established through detection of IgM antibody in serum samples of the patients using enzyme-linked immunosorbent assay (ELISA). The routine investigations for other systemic diseases were negative. CONCLUSIONS: Corneal endotheliitis as a sequela to mumps is a new reported association. Timely treatment with topical steroids led to resolution of the disease with full visual recovery without any residual symptoms or signs.- - - - - - - - - - ranking = 1keywords = corneal edema (Clic here for more details about this article) |
3/14. Diffuse lamellar keratitis and corneal edema associated with viral keratoconjunctivitis 2 years after laser in situ keratomileusis.A 47-year-old woman with a history of laser in situ keratomileusis (LASIK) 2 years previously for myopia and astigmatism, presented with bilateral loss of vision due to diffuse lamellar keratitis (DLK) with corneal edema in the context of a pseudomembranous viral keratoconjunctivitis. After intense and early treatment with topical corticosteroids, the corneal edema and DLK resolved and corneal transparency was achieved with complete restoration of visual acuity. This case shows that DLK may occur associated with a viral pseudomembranous keratoconjunctivitis in patients who have had LASIK. Diffuse lamellar keratitis may present up to 2 years after lamellar surgery, which would indicate that the plane created by the microkeratome at the interface may remain unhealed for at least this period of time. early diagnosis and treatment with topical corticosteroids can achieve complete resolution without visual loss.- - - - - - - - - - ranking = 6keywords = corneal edema (Clic here for more details about this article) |
4/14. calotropis procera (ushaar) keratitis.PURPOSE: To report a case of permanent endothelial cell injury after intracorneal penetration of milky latex from calotropis procera (ushaar). DESIGN: Interventional case report. methods: A 40-year-old patient developed painless corneal edema despite minimal epithelial injury after exposure to ushaar latex. RESULTS: Confocal and specular microscopy confirmed permanent endothelial cell loss with morphologic alteration after intracorneal penetration of ushaar latex. corneal edema resolved completely after 2 weeks, although reduced endothelial cell count and abnormal morphology persisted. CONCLUSION: Ushaar latex is capable of penetrating the corneal stroma and inducing permanent loss of endothelial cells. corneal edema resolves if sufficient endothelial cell viability is still present after resolution of ushaar keratitis.- - - - - - - - - - ranking = 1keywords = corneal edema (Clic here for more details about this article) |
5/14. Corneal toxicity and inflammation secondary to retained perfluorodecalin.PURPOSE: To describe a case with bullous keratopathy and anterior segment inflammation associated with heavy liquids. DESIGN: Observational case report. methods: review of clinical and histopathologic changes. RESULTS: A 65-year-old patient underwent a pars plana vitrectomy for a rhegmatogenous retinal detachment. Perfluorodecalin was used as a temporary retinal tamponade. After surgery, bubbles of heavy liquid were noted in the anterior chamber. Fifteen months later, severe corneal edema developed, associated with corneal vascularization and keratic precipitates. Removal of heavy liquid through a paracentesis was attempted but the cornea remained edematous, and a penetrating keratoplasty was performed. In the histopathologic examination inflammatory changes from retention of perfluorodecalin were observed. There was a decompensated cornea with florid bullous keratopathy, inflammatory infiltration with vascularization, and deposition of perfluorodecalin within keratocytes and perivascular macrophages. CONCLUSION: Presence of heavy liquids in the anterior chamber may be associated with an intense inflammatory response and corneal decompensation.- - - - - - - - - - ranking = 1keywords = corneal edema (Clic here for more details about this article) |
6/14. cytomegalovirus in aqueous humor from an eye with corneal endotheliitis.PURPOSE: To report cytomegalovirus (CMV) dna in aqueous humor from a patient with unilateral corneal endotheliitis. DESIGN: Case report. methods: A 51-year-old man presented with unilateral corneal endotheliitis with linear keratic precipitates and coin-shaped lesions. Tear and aqueous humor samples were subjected to polymerase chain reaction to look for dna from herpes simplex virus (HSV), varicella zoster virus (VZV), and CMV. RESULTS: aqueous humor from the diseased eye contained dna from CMV but not HSV or VZV. Its specificity was confirmed by Southern blot tests. Intravenous ganciclovir treatment resulted in the localization of his corneal edema and the reduction in keratic precipitates. There was severe destruction of corneal endothelial cells. CMV dna was not detected in tears or control samples. CONCLUSIONS: In this healthy man with corneal endotheliitis, we detected CMV dna in aqueous humor from the affected eye, but not HSV or VZV. This suggests that CMV may cause corneal endotheliitis in patients without immunodeficiency.- - - - - - - - - - ranking = 1keywords = corneal edema (Clic here for more details about this article) |
7/14. Interface corneal edema secondary to steroid-induced elevation of intraocular pressure simulating diffuse lamellar keratitis.PURPOSE: To describe interface corneal edema secondary to steroid-induced elevation of intraocular pressure (IOP) following LASIK. methods: Retrospective observational case series. Diffuse interface edema secondary to steroid-induced elevation of IOP was observed after LASIK simulating diffuse lamellar keratitis (DLK) in 13 eyes. Mean patient age was 31.4 /- 5.3 years. patients were divided into two groups according to provisional misdiagnosis: DLK group (group 1) comprised 11 eyes and infection group (group 2) comprised 2 eyes (microbial keratitis). Mean follow-up was 8.1 /- 0.5 weeks. RESULTS: In the DLK group, typical diffuse haze was confined to the interface and extended to the visual axis, impairing vision in all eyes. Provisional diagnosis was late-onset DLK and topical steroids were started. Repeat examination showed elevated IOP as measured at the corneal center and periphery using applanation tonometry (mean 19.1 mmHg and 39.5 mmHg, respectively), causing interface edema with evident interface fluid pockets. steroids were stopped and topical anti-glaucoma therapy was started. The interface edema decreased and at the end of follow-up the corneal transparency was restored and IOP dropped to normal values. The infection group demonstrated a microbial keratitis-like reaction and underwent flap lifting and interface wound debridement and biopsy with administration of fortified antibiotics and steroids. After elevated IOP was detected, steroids and antibiotics were stopped and topical anti-glaucoma therapy was started, resulting in the resolution of the interface edema. CONCLUSIONS: Interface fluid syndrome secondary to steroid-induced elevation of IOP might develop in steroid responders after LASIK with a misleading clinical picture simulating DLK or infectious keratitis. Management includes stopping topical steroids and starting topical antiglaucoma therapy.- - - - - - - - - - ranking = 5keywords = corneal edema (Clic here for more details about this article) |
8/14. Autoimmune endotheliopathy and chronic herpetic conjunctivitis.A migrating endothelial line of keratic precipitates associated with overlying corneal edema suggests an immune attack on the corneal endothelium. This is seen most commonly in corneal allotransplantation rejection. The etiology of such lines in the absence of this condition is unclear. We document the presence of an intranuclear virus compatible with herpesvirus in this condition.- - - - - - - - - - ranking = 1keywords = corneal edema (Clic here for more details about this article) |
9/14. The serratial 56K protease as a major pathogenic factor in serratial keratitis. Clinical and experimental study.A possible cause and the difference in clinical severity of serratial keratitis were investigated. Two strains of serratia marcescens were isolated: one from a patient with severe liquefactive keratitis, who had diabetes mellitus, and one from a patient with mild superficial keratitis, but who had no underlying disease. When the same numbers of bacteria were injected separately into corneas of the same rabbits or guinea pigs, the strain from the first patient elicited severe corneal destruction, remarkable intracorneal edema; and liquefactive necrosis, but the strain from the second caused mild keratitis with erosion or intracorneal abscess. The keratitis induced by the former strain required a longer time to heal, and the prognosis was poorer than that for the other keratitis. Therefore, the difference in severity between the two cases of experimentally induced keratitis paralleled that of the clinical cases. Thus, the severity of the serratial keratitis might be attributed more to the virulence of the bacteria than the condition of the host. The virulence factor seemed to be a heat-labile metabolic product (or products) of the bacteria. To clarify this virulence factor, the major secretory protease (56K protease) produced by these two strains of bacteria was compared by using in vitro and in vivo systems. The virulent strain produced about ten times more protease during culture than the less virulent strain. When injected into the corneas of experimental animals, the 56K protease from the virulent strain induced severe lesions similar to those caused by the living virulent strain of bacteria. These results indicated that one of the major factors causing the virulence was correlated with the tissue destructive 56K protease produced by S. marcescens.- - - - - - - - - - ranking = 1keywords = corneal edema (Clic here for more details about this article) |
10/14. Acute idiopathic corneal endotheliitis.Seven patients presenting with acute corneal stromal edema without prior surgery, trauma, ocular disease or known exposure to noxious agents are reported. One patient had a severe iridocyclitis; two others subsequently developed herpetic keratouveitis. Four cases, however, were unassociated with other known ocular disease. All four of these patients exhibited keratic precipitates and displayed minimal or no flare and cells in the anterior chamber, although the latter was largely obscured by the corneal edema. In each of these four instances, the inflammation and corneal edema resolved following topical corticosteroid therapy. In two of the four cases, both children, antibody to herpes simplex virus could not be identified. We suggest that, in patients without known prior corneal disease or trauma, acute diffuse corneal stroma edema may stem from severe iridocyclitis or a primary endotheliitis due either to herpetic infection, the recently described presumed autoimmune corneal endotheliopathy, or a condition which we herein designate acute idiopathic corneal endotheliitis.- - - - - - - - - - ranking = 2keywords = corneal edema (Clic here for more details about this article) |
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