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Acute interface fluid syndrome after laser in situ keratomileusis in a case of cytomegalovirus (CMV) endotheliitis and secondary glaucoma
  1. Sayali Tendolkar1,
  2. Somasheila I Murthy1,
  3. Kavya Chandran1 and
  4. Joveeta Joseph2
  1. 1Cornea and Anterior Segment Service, The Cornea Institute, Hyderabad, Telangana, India
  2. 2Jhaveri Microbiology Centre, LV Prasad Eye Institute, Hyderabad, Telangana, India
  1. Correspondence to Dr Somasheila I Murthy; smurthy{at}lvpei.org

Abstract

Cytomegalovirus (CMV) can cause recalcitrant recurrent keratouveitis and secondary glaucoma. We report a case of chronic recurrent anterior uveitis with secondary glaucoma presenting with acute visual loss and interface fluid 9 years after laser in situ keratomileusis. Based on clinical presentation, a viral aetiology was suspected. Aqueous tap was positive for CMV-DNA by real-time quantitative PCR of the aqueous humour. The patient was treated with systemic antivirals, topical corticosteroids and antiglaucoma medications. The interface fluid resorbed rapidly. The intraocular pressure (IOP) was controlled by trabeculectomy. There was no further corneal deterioration at 7-month follow-up and the IOP had also stabilised. We believe this is only the third reported case of CMV-related interface fluid syndrome. This case highlights the role of quantitative PCR analysis for establishing viral aetiology in recurrent unilateral hypertensive anterior uveitis and reports the unusual finding of interface fluid which resolved after starting systemic antiviral therapy.

  • anterior chamber
  • glaucoma

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Footnotes

  • Contributors SIM managed the case. SIM, ST and KC drafted the manuscript and designed the images. JJ provided virology support. Revision was done by SIM and JJ.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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