A CASE OF EPISCLERITIS AND CORNEAL ENDOTHELIITIS IN A PATIENT WITH SARCOIDOSIS

Title A CASE OF EPISCLERITIS AND CORNEAL ENDOTHELIITIS IN A PATIENT WITH SARCOIDOSIS
Author, Co-Author Nektaria Mandadakis, Daniella Rutner
Topic
Year
2008
Day
Friday
Program Number
85284
Room
Affiliation
State University of New York, College of Optometry
Abstract BACKGROUND: Corneal endotheliitis may assume disciform, diffuse or linear forms. If untreated, it may cause permanent visual loss due to endothelial decompensation and persistent corneal edema. The exact pathogenesis is not known, however, there are indications of a strong association with a viral origin.

CASE REPORT(S): A 33 year old black male presented with complaints of OS redness, for one month. Ocular history was remarkable for episcleritis of the same eye, 3 years ago. There was no significant medical history, although the patient did report a recurrent cough. Best-corrected visual acuity was 20/20 OD, 20/60 OS with a refraction of: plano-0.50x180 OD and -0.25-3.75x180 OS. Pupils were reactive to light, with no RAPD. Slit lamp examination revealed sectoral, nasal hyperemia, OS. Central endothelial irregularities with mild edema were further observed, OS. Pachymetry was 530/565, OD/OS. Episcleritis and endotheliitis OS were diagnosed, blood work was ordered and follow-up with a corneal specialist was requested in one week. One week later, the episcleritis resolved but the endotheliitis remained. The patient was also diagnosed with sarcoidosis, as a result of the blood tests. Muro ung qhs OS was initiated. One week later, vision was improved to 20/50, the endothelial irregularities persisted, though no edema was noted. The patient’s condition remains stable.

CONCLUSIONS: Most reported cases of endotheliitis have been in association with Herpes Simplex Keratitis and Cytomegalovirus. Sarcoidosis is another important differential diagnosis of endotheliitis. Treatment with topical steroids and hyperosmotic agents is aimed at reducing corneal edema, to prevent permanent endothelial dysfunction. PK and DSAEK are alternative treatment options when visual acuity decreases and activities of daily living are compromised.
Affiliation of Co-Authors State University of New York, College of Optometry
Outline