title: Infectious crystalline keratopathy with ring opacity.
abstract: A 41-year-old physician was treated for 3 months with antiviral medications, antibiotics, and steroids for presumed herpetic keratitis. When seen by us, an annular infiltrate was observed, along with crystalline-like opacities in the superficial one third of the stroma. Cultures of scrapings and of subsequent biopsies were positive for Streptococcus mitis of the viridans group; histopathology demonstrated large aggregates of cocci between the stroma lamellae. Tapering of topical corticosteroids and treatment with topical penicillin resulted in resolution of the infiltrates. The clinical appearance and findings in this patient suggest that infectious crystalline keratitis can produce an annular infiltrate. Injection of the organism into rabbit corneas produced a crystalline infiltrate, but no annular opacity was observed. Corticosteroids altered the clinical and histopathologic appearance of the lesions in rabbits.
authors.affiliation: Doheny Eye Institute, University of Southern California, School of Medicine, Los Angeles 90033.
authors.forename: J M
authors.initials: JM
authors.lastname: McDonnell
authors.forename: D C
authors.initials: DC
authors.lastname: Gritz
authors.forename: D
authors.initials: D
authors.lastname: Hwang
authors.forename: P J
authors.initials: PJ
authors.lastname: McDonnell
mesh_terms: D000328:Adult; D000818:Animals; D003315:Cornea / Q000382:microbiology; D003318:Corneal Opacity / Q000188:drug therapy / Q000382:microbiology*; D003319:Corneal Stroma / Q000187:drug effects / Q000382:microbiology; D003460:Crystallization; D004195:Disease Models, Animal; D004917:Erythromycin / Q000627:therapeutic use; D015818:Eye Infections, Bacterial; D006801:Humans; D007634:Keratitis / Q000188:drug therapy / Q000382:microbiology*; D008775:Methylprednisolone / Q000008:administration & dosage; D010406:Penicillins / Q000627:therapeutic use; D011817:Rabbits; D013290:Streptococcal Infections; D013291:Streptococcus / Q000254:growth & development
chemical_list: D010406:Penicillins; D004917:Erythromycin; D008775:Methylprednisolone