The use of in vivo confocal microscopy
has been valuable in detecting and managing corneal pathology. This case study documents endotheliitis
using in vivo confocal microscopy
where apparent resolution of endothelial edema on clinical examination resulted in the discovery of subclinical findings with confocal scanning. The purpose of this case study was to discuss a rare corneal pathology and the clinical value of confocal scanning.
A 30-year-old Asian Indian woman presented with unilateral endotheliitis
and trabeculitis of presumed varicella zoster virus
etiology. She was treated successfully with oral antiviral and topical corticosteroid therapy. Subclinical endotheliitis
was detected using in vivo confocal microscopy
, prompting the continuation of prophylactic, low-dose, topical corticosteroid therapy and topical hyperosmotics.
Further research is warranted to better understand the role of confocal microscopy
therapeutic management, endothelial cell count and morphology, and keratic precipitate characterization. To date, prophylactic oral antivirals and/or topical corticosteroids may play a role in immune suppression of the herpes virus, although prospective, randomized, controlled clinical trials have not focused specifically on endotheliitis