Ocular post-transplant lymphoproliferative disorder after keratoplasty.

PURPOSE

Epstein-Barr virus associated post-transplantation lymphoproliferative disorders (PTLD) is a common condition after solid-organ or allogeneic hematopoietic stem-cell transplants. But ocular involvement after keratoplasty remains a rare finding, and can be easily misdiagnosed.

OBSERVATIONS

We report a case of a 59-year-old man who presented with masquerade uveitis of right eye 4 months post penetrating keratoplasty and was ultimately diagnosed with ocular PTLD. The diagnosis relied on the presence of Epstein-Barr virus DNA in aqueous sample and iris specimens showed the presence of a B cell clone. The ocular condition was in complete remission after 15 intravitreal injections of methotrexate.

CONCLUSIONS AND IMPORTANCE

Local immunosuppression after keratoplasty can lead to ocular PTLD. Detection of Epstein-Barr virus DNA in intraocular fluid and tissue or cytological biopsy could help confirm the diagnosis.