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Management of cytomegalovirus corneal Endotheliitis

Eye and Vision 2021年第1期8卷 18-30页

作者： Angela H.Y.Wong Wee Nie Kua Alvin L.Young Kelvin H.Wan Department of Ophthalmology Tuen Mun HospitalHong KongChina Department of Ophthalmology and Visual Sciences Prince of Wales HospitalHong KongChina Department of Ophthalmology and Visual Sciences The Chinese University of Hong KongHong KongChina

Background:Cytomegalovirus(CMV)can manifest as corneal Endotheliitis in immunocompetent individuals.Early diagnosis is prudent to prevent endothelial cell loss,which could ultimately lead to corneal decompensation.CMV DNA was first detected in an eye with corneal Endotheliitis in 2006;since then,clinical evidence from numerous case reports and case series have accumulated.Main text:In this narrative review,we identified several drugs,including ganciclovir,valganciclovir,and their combination in oral,intravenous,intravitreal,and topical forms in different concentrations,together with the judicious use of topical steroids,have reported variable success.There has yet to be any prospective comparative study evaluating the efficacy and safety of these assorted forms of treatment;clinical evidence is based on case reports and case series.CMV Endotheliitis presenting with corneal edema can masquerade as other corneal diseases and thus poses a great challenge especially in post-keratoplasty eyes.Heightened awareness is needed before and after keratoplasty to start prompt prophylaxis and treatment.Conclusion:There is no consensus on the management of CMV Endotheliitis.Further studies are much needed to elucidate the optimal treatment modality,regime,and duration in the treatment and prophylaxis of CMV Endotheliitis.

关键词： Cytomegalovirus CMV Endotheliitis Keratoplasty Corneal transplant Cornea

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Adenovirus-mediated corneal Endotheliitis: a case report

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International Journal of Ophthalmology(English edition) 2019年第10期12卷 1659-1661页

作者： Shuang-Yong Wang Bei Li Dong-Hao Li Ying Tian The Third Affiliated Hospital Guangzhou Medical University

Dear Editor,CornealEndotheliitisisacommonandintriguing clinicalentitycharacterizedbycornealedema,keratic precipitates,and mild to moderate anterior chamber reaction,which occupies the important pathogenic factor of corneal blindness[1].Robin et al[2]first described a patient who suffered from intraocular inflammation and progressive corneal Endotheliitis associated with herpes simplex infection.Since then,accumulating clinical evidence confirmed that its etiology was mainly attributed to the family of herpesviridae,including herpes simplex virus,varicella zoster virus,and cytomegalovirus,which initiated the direct cell damage and immune-and inflammatory-mediated lesion on endothelial cells[1,3].

关键词： Adenovirus-mediated corneal Endotheliitis a case report

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Perioperative topical ascorbic acid for the prevention of phacoemulsification-related corneal endothelial damage:Two case reports and review of literature

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World Journal of Clinical Cases 2019年第5期7卷 642-649页

作者： Chia-Yi Lee Hung-Ta Chen Yi-Jen Hsueh Hung-Chi Chen Chieh-Cheng Huang Yaa-Jyuhn James Meir Chao-Min Cheng Wei-Chi Wu Department of Ophthalmology Show Chwan Memorial Hospital Department of Optometry College of Medicine and Life Science Chung Hwa University of Medical Technology Department of Internal Medicine Taipei City Hospital-Heping Branch Department of Ophthalmology Chang Gung Memorial Hospital Center for Tissue Engineering Chang Gung Memorial Hospital Department of Medicine College of Medicine Chang Gung University Institute of Biomedical Engineering National Tsing Hua University Department of Biomedical Sciences College of Medicine Chang Gung University

BACKGROUND The current case report describes successful phacoemulsification with the aid of perioperative topical ascorbic acid(AA) in two patients with corneal endothelial disorders to prevent postoperative corneal endothelial decompensation.CASE SUMMARY Two eyes of two patients underwent phacoemulsification with pre-existing corneal endothelial disorders including Fuchs corneal endothelial dystrophy(Patient 1) and Endotheliitis(Patient 2). Topical AA was applied to both patients at least one month before and after with a frequency of four times per day. After the surgery, both eyes improved best-corrected visual acuity(BCVA) and there was limited human corneal endothelial cell loss without signs of corneal endothelial decompensation, such as deteriorated BCVA or persistent corneal edema during the follow-up of at least two years.CONCLUSION Perioperative administration of topical AA may be an alternative therapy to the triple procedure in patients expecting to undergo cataract surgery.

关键词： Ascorbic acid Fuchs corneal endothelial dystrophy Endotheliitis Human corneal endothelial cell Phacoemulsification Case report

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