Progressive herpetic linear endotheliitis.
OBJECTIVE
To report the clinical course of a rare case of bilateral herpetic linear endotheliitis.


METHODS
A 70-year-old man presented with bilateral circumferential bullous edema with stromal edema progressing centrally in the left cornea and bilateral sensorineural hearing impairment simultaneously. Serum immunoglobulin G (IgG) and IgM antibodies against herpes simplex virus type 1 (HSV1) were tested for, and aqueous humor from both eyes was examined separately using polymerase chain reaction for the presence of HSV1 DNA.


RESULTS
Serum antibody titers against HSV1 were positive. In the polymerase chain reaction, the aqueous humor showed HSV1 DNA in both eyes. Forty milligrams of prednisolone was given per day and 200 mg of oral acyclovir was given 4 times daily, but corneal edema progressed. After penetrating keratoplasty surgery in the left eye, recurrent herpetic endotheliitis also seemed to occur.


CONCLUSIONS
HSV-1 may cause bilateral corneal linear endotheliitis and hearing impairment simultaneously. Linear endotheliitis should be regarded as a manifestation of HSV1 corneal infection. There is a poor prognosis, and severe corneal edema can result if aggressive treatment is not used.
Shen
Ying-Cheng
YC
Department of Ophthalmology, Taichung Veterans General Hospital, Taiwan, China. eric550131@yahoo.com.tw
Wang
Chun-Yuan
CY
Chen
Yu-Chen
YC
Lee
Yi-Fen
YF
D000212:Acyclovir / Q000627:therapeutic use; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D001082:Aqueous Humor / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D018450:Disease Progression; D004359:Drug Therapy, Combination; D004728:Endothelium, Corneal / Q000821:virology*; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D016849:Keratitis, Herpetic / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D015948:Keratoplasty, Penetrating; D008297:Male; D016133:Polymerase Chain Reaction; D011239:Prednisolone / Q000627:therapeutic use
D000914:Antibodies, Viral; D004279:DNA, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D011239:Prednisolone; D000212:Acyclovir