Related Experiment Video
Updated: Dec 8, 2025
Separation of Immune Cell Subpopulations in Peripheral Blood Samples from Children with Infectious Mononucleosis
Published on: September 7, 2022
Delayed-onset Bilateral Peripheral Posterior Interstitial Keratitis Associated with Epstein-Barr Virus-Induced
Alfonso Iovieno1,2, Marco Coassin1,3, Fabiana Viscogliosi4
1Department of Ophthalmology, Azienda USL - IRCCS, Reggio Emilia, Italy.
Introduction:
Epstein-Barr Virus (EBV) has been previously reported to cause rare occurrence of mostly epithelial and nummular keratitis. We hereby report two patients developing bilateral peripheral deep interstitial keratitis following EBV-related infectious mononucleosis (IM).
Description Of Cases:
Two female adolescents presented with findings of chronic relapsing posterior interstitial keratitis with neovascularisation mostly located in the superior and inferior peripheral cornea, in absence of signs of anterior uveitis. The disease presented months after the occurrence of IM. Other etiologies of interstitial keratitis were excluded. EBV DNA could not be detected in the aqueous humor of both patients. The patients responded promptly to topical corticosteroids, with multiple recurrences reported in one case.
Conclusion:
EBV-induced IM can cause bilateral peripheral interstitial keratitis with delayed onset. Progressive relapsing course of the keratitis can be observed.
Insights
Epstein-Barr Virus (EBV) can cause delayed-onset, bilateral peripheral interstitial keratitis after infectious mononucleosis (IM). This rare complication may present with a relapsing course, requiring prompt corticosteroid treatment.
Area of Science:
- Ophthalmology
- Virology
- Immunology
Background:
- Epstein-Barr Virus (EBV) is a known cause of rare ocular manifestations, primarily epithelial and nummular keratitis.
- This study investigates a less common presentation of EBV-related eye disease.
Purpose of the Study:
- To report two cases of bilateral peripheral deep interstitial keratitis following EBV-related infectious mononucleosis (IM).
- To highlight the delayed onset and potential relapsing nature of this specific keratitis presentation.
Main Methods:
- Case report of two female adolescents with chronic relapsing posterior interstitial keratitis.
- Exclusion of other etiologies and negative EBV DNA in aqueous humor.
- Treatment with topical corticosteroids and observation of disease course.
Main Results:
- Both patients developed bilateral peripheral deep interstitial keratitis with neovascularization months after IM.
- The keratitis was posterior and interstitial, predominantly in the superior and inferior peripheral cornea.
- Patients responded well to topical corticosteroids, though one experienced recurrences.
Conclusions:
- EBV-induced infectious mononucleosis can lead to delayed-onset, bilateral peripheral interstitial keratitis.
- The keratitis may follow a progressive and relapsing course.
- This presentation underscores the diverse ocular complications associated with EBV.
