Demonstration of "owl's eye" morphology by confocal microscopy in a patient with presumed cytomegalovirus corneal endotheliitis.
OBJECTIVE
To report confocal microscopic observations of characteristic corneal endothelial lesions in a patient with presumed cytomegalovirus (CMV) corneal endotheliitis.


METHODS
Case report.


METHODS
A 77-year-old, immunocompetent man was admitted with corneal edema, keratic precipitates, and coin-shaped lesions in the right eye. Confocal microscopy was performed to examine the corneal endothelium. Polymerase chain reaction (PCR) was used to identify viral DNA in an aqueous humor sample.


RESULTS
CMV DNA was detected by PCR. Confocal microscopy showed large corneal endothelial cells with an area of high reflection in the nucleus surrounded by a halo of low reflection. This "owl's eye" morphology is characteristic of CMV infection. Topical and intravenous ganciclovir treatment resulted in rapid resolution of the corneal precipitates and edema, followed by disappearance of the owl's eye morphology.


CONCLUSIONS
Confocal microscopy can detect the owl's eye morphology in the corneal endothelium of patients with presumed CMV corneal endotheliitis.
Shiraishi
Atsushi
A
Department of Ophthalmology, Ehime University School of Medicine, Shitsukawa, Toon, Ehime, Japan. shiraia@m.ehime-u.ac.jp <shiraia@m.ehime-u.ac.jp>
Hara
Yuko
Y
Takahashi
Miyabi
M
Oka
Naoko
N
Yamaguchi
Masahiko
M
Suzuki
Takashi
T
Uno
Toshihiko
T
Ohashi
Yuichi
Y
D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D001082:Aqueous Humor / Q000821:virology; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D004728:Endothelium, Corneal / Q000473:pathology*; D015828:Eye Infections, Viral / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D007634:Keratitis / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D008297:Male; D018613:Microscopy, Confocal; D016133:Polymerase Chain Reaction
D000998:Antiviral Agents; D004279:DNA, Viral; D015774:Ganciclovir