Indian Journal of Ophthalmology

OPHTHALMIC IMAGE
Year
: 2020  |  Volume : 68  |  Issue : 1  |  Page : 207-

Precipitation of herpetic stromal keratitis after collagen cross-linking for keratoconus


Sudhakar Potti, Parag Anil Bagad, Nadim Khatib, Akhil Bevara 
 Sankara Eye Hospital, Guntur, Andhra Pradesh, India

Correspondence Address:
Dr. Sudhakar Potti
Sankara Eye Hospital, Guntur -Vijayawada Expressway, Pedakakani, Guntur - 522 509, Andhra Pradesh
India




How to cite this article:
Potti S, Bagad PA, Khatib N, Bevara A. Precipitation of herpetic stromal keratitis after collagen cross-linking for keratoconus.Indian J Ophthalmol 2020;68:207-207


How to cite this URL:
Potti S, Bagad PA, Khatib N, Bevara A. Precipitation of herpetic stromal keratitis after collagen cross-linking for keratoconus. Indian J Ophthalmol [serial online] 2020 [cited 2020 Oct 22 ];68:207-207
Available from: https://www.ijo.in/text.asp?2020/68/1/207/273186


Full Text



A 22-year-old-male in whom collagen cross-linking (CXL) was done elsewhere 3 years ago for keratoconus presented with 4 × 3 mm deep corneal neovascularization [Figure 1]a in arborizing pattern [confirmed with corneal fluorescein angiography [Figure 1]c and [Figure 1]d] involving midstroma [confirmed with anterior-segment optical coherence tomography (OCT) [Figure 1]b)] with feeder vessels from 5 o'clock limbus in left eye. A presumptive diagnosis of chronic herpetic stromal keratitis was made and treated with oral acyclovir and topical low-dose steroids, causing partial regression of neovascularization with appearance of ghost vessels [Figure 1]e and [Figure 1]f.{Figure 1}

Ultraviolet-A (UVA) light, epithelial/stromal trauma, or actual damage to corneal nerves during Collagen cross-linking (CXL) could trigger reactivation of latent Herpes infections even in patients with no previous history.[1],[2]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Kymionis GD, Portaliou DM, Bouzoukis DI, Suh LH, Pallikaris AI, Markomanolakis M, et al. Herpetic keratitis with iritis after corneal crosslinking with riboflavin and ultraviolet A for keratoconus. J Cataract Refract Surg 2007;33:1982-4.
2Yuksel N, Bilgihan K, Hondur AM. Herpetic keratitis after corneal collagen cross-linking with riboflavin and ultraviolet-A for progressive keratoconus. Int Ophthalmol 2011; 31:513-5.