[Diagnosis and treatment of cytomegalovirus endotheliitis]

Cytomegalovirus endotheliitis is an inflammation of the corneal endothelium caused by cytomegaloviruses. It may represent a newly identified clinical entity that has drawn increasing attention since cytomegalovirus DNA was detected from the aqueous humor of a patient with corneal endotheliitis. Its pathogenesis is still unclear, and it typically presents as corneal edema, coin-shaped/linear keratic precipitates, mild anterior chamber inflammation and with or without raised intraocular pressure in an otherwise healthy individual. In order to make an accurate diagnosis, the patient's medical history, clinical manifestations and ocular signs should all be considered, and further detection of pathogens by PCR from the ocular tissue should be done. However, misdiagnoses may occur because cytomegalovirus endotheliitis can mimic other clinical diagnoses. Patients with cytomegalovirus endotheliitis respond to systemic and topical ganciclovir with the use of topical steroids. Therefore, making an accurate early diagnosis is crucial in preventing loss of corneal endothelial cells. Moreover, if left undiagnosed, these eyes often receive increasing amounts of immunosuppressants in attempts to control the inflammation, which may worsen the ocular infection, thus compromising their visual outcomes.