title: Eighteen months of anterior chamber inflammation.
abstract: A 60-year-old Chinese patient was seen multiple times in the ophthalmology outpatient department due to persistent anterior-chamber inflammation and raised intraocular pressure. The patient was being treated with topical corticosteroids and oral acyclovir. Signs of corneal endotheliitis were observed in subsequent follow-ups. A clinical diagnosis could be made on slit-lamp examination, but aetiology could not be specified. An anterior-chamber diagnostic tap performed 18 months after the initial presentation revealed cytomegalovirus (CMV). Prompt response was noted with oral valganciclovir treatment. Our case highlights the importance of performing anterior-chamber tap in cases with persistent anterior-chamber inflammation. There was a long interval between the presentation and diagnosis mainly due to the absence of any concurrent ocular signs. An anterior-chamber tap was delayed until the ocular signs were suggestive of CMV endotheliitis. Timely diagnosis in such cases can improve the outcome as well as the prognosis.
authors.affiliation: Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong. vishaljhanji@gmail.com
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
authors.forename: Rachel
authors.initials: R
authors.lastname: Kwok
authors.forename: Alvin L
authors.initials: AL
authors.lastname: Young
mesh_terms: D000867:Anterior Chamber; D001082:Aqueous Humor / Q000821:virology*; D003586:Cytomegalovirus Infections / Q000175:diagnosis*; D057210:Delayed Diagnosis; D004728:Endothelium, Corneal; D006801:Humans; D007634:Keratitis / Q000821:virology*; D008875:Middle Aged; D019152:Paracentesis; D013997:Time Factors