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Herpes simplex keratitis in renal transplant patients
1Department of Ophthalmology, Beilinson Medical Center, Petah Tiqva, Israel.
The British Journal of Ophthalmology
|February 1, 1991
Summary
Kidney transplant patients can develop atypical herpetic dendritic keratitis, characterized by peripheral corneal lesions and delayed healing, likely due to immunosuppression. This condition requires prolonged antiviral treatment and can lead to scarring.
Area of Science:
- Ophthalmology
- Transplant Surgery
- Immunology
Background:
- Herpetic keratitis is a common cause of corneal disease.
- Immunosuppression in transplant recipients can alter disease presentation.
- Atypical presentations of herpetic keratitis are not well-documented in post-transplant patients.
Purpose of the Study:
- To describe the atypical clinical presentation of herpetic dendritic keratitis in kidney transplant recipients.
- To investigate the treatment response and outcomes of this condition.
Main Methods:
- Retrospective case review of kidney transplant patients.
- Clinical examination and documentation of ocular findings.
- Analysis of treatment response to acyclovir therapy.
Main Results:
- Five out of 430 kidney transplant patients (1.16%) developed atypical herpetic dendritic keratitis within four weeks post-surgery.
- Lesions were characterized by multiple peripheral dendrites in relatively uninflamed eyes.
- Acyclovir treatment showed a prolonged response (≥3 weeks).
- All patients developed subepithelial infiltrates and scarring; disciform keratopathy was absent.
Conclusions:
- Kidney transplant recipients may present with an atypical form of herpetic dendritic keratitis.
- The immunosuppressed state likely contributes to the altered clinical course and delayed healing.
- This presentation necessitates prolonged antiviral therapy and monitoring for corneal scarring.