Department of Ophthalmology, Keiyu Hospital, 3-7-3 Minatomirai, Yokohama Nishi-ku, Kanagawa, 220-8521, Japan.
BMC Ophthalmol. 2022 Jan 21;22(1):31. doi: 10.1186/s12886-022-02257-6.
A case of Epstein-Barr viral (EBV) corneal stromal keratitis during rheumatoid arthritis (RA) treatment is presented.
A 74-year-old female undergoing RA treatment was previously treated for bacterial corneal ulcer and herpetic keratitis and healed with antibiotic eye drops and topical anti-herpes ointment. At the first visit to our hospital, she presented with findings of monocular posterior interstitial keratitis with neovascularization mostly located in the inferior cornea with a corneal epithelial defect. The right eye showed no thinning of the corneal periphery and anterior uveitis. Her RA had subsided with oral steroid treatment, and infectious mononucleosis (IM) had not developed. EBV DNA could be detected in her corneal sample. After an extended but ineffective period to antibiotic treatment the corneal infiltrate responded rapidly to topical corticosteroids.
EBV can cause stromal keratitis without IM during treatment for RA.
本文报告了一例类风湿关节炎（RA）治疗期间发生的 Epstein-Barr 病毒（EBV）角膜基质角膜炎病例。
一名 74 岁女性正在接受 RA 治疗，曾因细菌性角膜溃疡和疱疹性角膜炎接受治疗，经抗生素眼药水和局部抗病毒软膏治疗后痊愈。她首次就诊于我院时，右眼表现为单眼后部间质性角膜炎，伴有新生血管形成，主要位于下方角膜，伴有角膜上皮缺损。右眼周边角膜无变薄，无前葡萄膜炎。她的 RA 经口服类固醇治疗后已缓解，且未发生传染性单核细胞增多症（IM）。在她的角膜样本中可检测到 EBV DNA。在抗生素治疗延长但无效后，角膜浸润对局部皮质类固醇迅速产生反应。
在 RA 治疗期间，EBV 可引起无 IM 的基质角膜炎。
