Stromal Keratitis After Varicella in Children
Margot Denier1, Eric Gabison1, Marwan Sahyoun1
1Department of Ophthalmology, A de Rothschild Foundation Hospital, Paris, France; and.
Cornea
|March 3, 2020
Summary
Stromal keratitis following chickenpox in children can become chronic, often requiring prolonged treatment. Management challenges include steroid dependence and relapses during tapering.
Area of Science:
- Ophthalmology
- Pediatric Infectious Diseases
- Corneal Diseases
Background:
- Stromal keratitis is a serious eye condition that can occur after chickenpox (varicella) in children.
- This manifestation can lead to a chronic course, posing management challenges.
Purpose of the Study:
- To describe a case series of children with chronic stromal keratitis following varicella.
- To analyze treatment outcomes and identify management challenges.
Main Methods:
- Retrospective review of 8 eyes in 7 children diagnosed with stromal keratitis after varicella.
- Treatment involved systemic acyclovir and topical steroids, with topical cyclosporine added for steroid dependence or side effects.
- Anti-inflammatory treatments were slowly tapered over time.
Main Results:
- The median age at diagnosis was 3 years and 4 months.
- Most cases were unilateral, presenting as superficial or deep stromal keratitis.
- During a median follow-up of 31 months, 6 children experienced 1-6 relapses.
- Median topical steroid duration was 26 months; 43% received adjunctive topical cyclosporine.
- All patients achieved 20/20 best-corrected visual acuity by the end of follow-up.
Conclusions:
- Stromal keratitis post-varicella can have a chronic course exceeding 3 months.
- Steroid dependence and relapses during treatment tapering are significant management hurdles.
