[A case of necrotizing scleritis associated with Epstein-Barr virus infection]

Recently Epstein-Barr virus (EBV) is often reported in association with ocular disease. But EBV has not been reported to cause necrotizing scleritis. A 71-year-old woman developed ciliary injection and peripheral corneal ulcer in both eyes. The lesions did not respond to topical steroid and systemic indomethacin. The sclera became transparent and perforated. EBV serologic antibody titers were strongly positive. Anti-viral capsid antigen (VCA)-IgG was 1: 1,280 and anti-early antigen (EA)-IgG was 1: 640. These serologic results suggested active EBV infection. Using immunofluorescence techniques, the squamous epithelial cells of the conjunctiva were stained with monoclonal antibody against EBV-VCA and strongly stained with antibody against IgG. The results of serologic test and the immunofluorescence techniques appeared to suggest that the necrotizing scleritis was caused by EBV.