Disciform keratitis

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BACKGROUND: Bilateral keratitis is rare and can have various causes. For a good outcome after treatment, the correct diagnosis is decisive. CASE REPORT: A 15-year-old boy presented to our clinic with recurrent keratoconjunctivitis and progressive loss of vision in both eyes since 6 years. The best corrected visual acuity was 0.1 in the right eye and 1/12 in the left eye. Slit-lamp examination verified keratitis disciformis with strongly vascularized corneal stromal scars without conjunctival follicles on both sides...

A 44-year-old man presented with severe pain, redness, watering and photophobia for 10 days in the right eye without any history of trauma. Diagnosis of herpes simplex disciform keratitis was made and he was prescribed topical steroids. The patient showed clinical worsening and presented with ring infiltrate, diffuse stromal oedema and radial keratoneuritis, a finding pathognomic of acanthamoeba keratitis. With two inconclusive corneal scrapings and the patient showing clinical worsening, an urgent therapeutic penetrating keratoplasty was carried out...

PURPOSE: Biomicroscopy is generally used, sometimes in conjunction with photography or ultrasound pachymetry, to monitor conditions involving stromal keratitis and edema. Spectral-domain optical coherence tomography (SD-OCT), a technology typically used to examine the posterior segment, may be useful in monitoring the therapeutic interventions for conditions involving corneal edema such as disciform keratitis. CASE REPORTS: Two cases of disciform keratitis were followed to resolution using SD-OCT with anterior segment imaging software (Cirrus 4000; Carl Zeiss Meditec, Dublin, CA) to quantify decreasing edema throughout treatment...

AIMS: To classify the clinical stages of Acanthamoeba keratitis (AK), and clarify the relationship between pathological changes and clinical features. METHODS AND RESULTS: Between January 2007 and May 2012, AK was diagnosed in 11 eyes by pathological examination and confocal laser scanning microscopy. Pathological investigation of all cornea samples from keratoplasty was done with periodic acid-Schiff and haematoxylin and eosin stains. AK clinical stage, pathological features and postoperative treatment were studied retrospectively...

A case of an immunocompetent 51-year-old healthy man with chronic recurrent disciform corneal oedema and hypertensive anterior uveitis in the right eye for 2 years was unresponsive to topical corticosteroid and systemic acyclovir. Diagnostic anterior chamber tapping was performed and viral DNA PCR was positive for both cytomegalovirus and herpes simplex virus. The patient was treated with both oral valganciclovir for 3 months and long-term oral acyclovir. His condition improved significantly after the treatment; intraocular pressure and anterior chamber inflammation were controlled and the remaining keratic precipitates in the cornea started to clear up...

Reiter's syndrome is commonly associated with conjunctivitis and rarely with uveitis. Bilateral disciform keratitis at presentation is a very rare manifestation in Reiter's syndrome. A 13-year-old boy developed bilateral disciform keratitis with oligoarthritis following an episode of conjunctivitis. In addition he had suspected bacterial keratitis with hypopyon in the left eye as a possible secondary infection of an epithelial defect that is a feature of Reiter's keratitis. Empirical treatment with intensive topical antibiotics as a therapeutic trial completely resolved the hypopyon and the disciform keratitis settled with topical steroid treatment...

An unusual case of disciform keratitis developing in a patient with silicone oil-filled eye following vitrectomies for posterior globe rupture.

OBJECTIVE: To study the cellular morphological characteristics and changes of corneal endotheliitis by corneal microstructure in vivo. METHODS: Forty-eight clinical diagnosed patients of corneal endotheliitis were examined by in vivo confocal microscopy. Confocal images of different layers were collected and observed. Of all the patients, 39 were disciform and 9 were diffuse. The history of the 48 patients was from 7 days to 23 years and the duration was from 4 to 180 days...

Herpes simplex virus (HSV) is a common cause of keratitis. "Herpetic keratitis" is a chameleon, which is well treatable today if the various types of clinical expression of this disease are known to the ophthalmologist and treatment is adjusted accordingly. Types of expression include 1. epithelial keratitis (dendritica/geographica), 2. stromal keratitis (necrotizing vs. non-necrotizing = "interstitial keratitis"), 3. endotheliitis (=disciform keratitis), 4. neurotrophic keratopathy (=so-called metaherpetic keratitis) and 5...

The management of herpes zoster (HZ) usually involves a multidisciplinary approach aiming to reduce complications and morbidity. Patients with herpes zoster ophthalmicus (HZO) are referred to ophthalmologists for prevention or treatment of its potential complications. Without prompt detection and treatment, HZO can lead to substantial visual disability. In our practice, we usually evaluate patients with HZO for corneal complications such as epithelial, stromal, and disciform keratitis; anterior uveitis; necrotizing retinitis; and cranial nerve palsies in relation to the eye...

PURPOSE: To report a case of varicella endotheliitis. METHODS: An 18-year-old patient with varicella presented with photophobia and reduced vision in his left eye because of disciform corneal endotheliitis. RESULTS: Ocular symptoms and signs resolved completely except for small sectoral iris atrophy with combined antiviral and corticosteroid therapy. CONCLUSIONS: We report a rare presentation of varicella.

PURPOSE: To report bilateral Acanthamoeba keratitis after wearing an overnight reverse geometry contact lens for 5 days. METHODS: Case report and review of the medical literature. RESULTS: A 22-year-old woman developed bilateral corneal ulcers during orthokeratology. A slit-lamp examination revealed round epithelial abrasion, radial infiltration, and disciform keratitis in both corneas. Visual acuity in her right eye (OD) was hand motion and left eye (OS) was counting fingers...

A 40-year-old woman presented with an unusual form of corneal herpetic reactivation 5 weeks after laser in situ keratomileusis. The cornea showed diffuse edema and a stromal ring infiltrate (disciform in appearance). Oral antiviral and topical steroids in tapered dosages were administered. The infiltrate disappeared within 6 weeks. Progressive improvement was also seen in all the parameters on Pentacam scans, including the pachymetry, keratometry readings, and elevation on the anterior float. Herpetic reactivation may occur in many forms after excimer laser ablation...

PURPOSE: To report bilateral Acanthamoeba keratitis after wearing an overnight reverse geometric contact lens for 5 days. METHODS: Case report and review of the medical literature RESULTS: A 22-year-old woman developed bilateral corneal ulcers during orthokeratology. A slit-lamp examination showed round epithelial abrasion, radial infiltration, and disciform keratitis in both corneas. Visual acuity OD was hand motion and OS was counting fingers...

OBJECTIVE: To validate photographic bioimaging for evaluating the severity of herpes simplex virus keratitis. METHODS: Stromal keratitis of patients in the Herpetic Eye Disease Study was clinically measured with a slitbeam micrometer and then photographed at trial entry. Calibrated images of 169 eyes were analyzed for the size, location, and density of stromal keratitis and endotheliitis, with shape factor as a function of area and perimeter. Validity was assessed by comparing clinical and computerized measurements and by correlating the keratitis area with visual acuity...

Corneal endotheliitis is an intriguing clinical entity manifested by corneal edema, keratic precipitates, and mild anterior chamber reaction, and can be defined as a spectrum of the disorder in which the corneal endothelium is the primary site of the inflammation. The disease etiology consists of accumulating evidence of various viral infections including herpes simplex virus, varicella zoster virus, and cytomegalovirus. Corneal endotheliitis can be classified clinically into four forms: linear, sectorial, disciform, and diffuse...

PURPOSE: To report a case of macular hole secondary to Bartonella henselae neuroretinitis. METHODS: Observational case report. An 11 year-old boy presented urgently with a decrease of visual acuity in the left eye. Posterior segment examination revealed neuroretinitis attributed to Bartonella henselae. Treatment was initiated, resulting in the disappearance of symptoms. RESULTS: Follow-up consultations 7 months later showed a further decline in visual acuity secondary to a macular hole...

PURPOSE: This study was designed to report a case of acanthamoeba keratitis in a 5-year-old child without a history of trauma or contact lens usage. METHODS: The history, clinical presentation, diagnostic, and therapeutic approaches were reviewed. RESULTS: A 5-year-old child without any history of trauma or contact lens use was referred to our university clinic with an initial diagnosis of disciform herpetic keratitis. After 2 weeks of antibacterial and antiviral therapy, a corneal biopsy was performed for diagnostic purposes...

PURPOSE: To document the clinical pattern in recurrent herpes simplex disease. METHODS: Eyes with clinically documented pattern of corneal manifestation on more than one occasion were analysed. For each eye recruited, the clinical pattern of the disease at each recurrence of herpes simplex corneal disease, age, disease-free intervals, triggering factors, laterality and steroid abuse were noted and evaluated. RESULTS: For an average follow up of 6...