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Mpox Keratitis: A Case Report and Review.
Croasdale, Christopher R; Weinlander, Eric; Boyce, Thomas G.
Afiliación
  • Croasdale CR; SSM Health, Davis Duehr Dean Clinic, Madison, WI.
  • Weinlander E; Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI ; and.
  • Boyce TG; Pediatric Infectious Diseases, Marshfield Clinic, Marshfield, WI.
Cornea ; 43(10): 1319-1331, 2024 Oct 01.
Article en En | MEDLINE | ID: mdl-38967497
ABSTRACT

PURPOSE:

Mpox is a rare infectious disease. Lack of knowledge among eye care professionals regarding mpox keratitis greatly reduces the likelihood of diagnosis and effective management. This report and review seek to increase the knowledge of mpox keratitis among eye care professionals.

METHODS:

We report a patient with mpox keratitis who underwent successful penetrating keratoplasty, with 20 years of follow-up. A systematic literature search and review of cases of mpox keratitis from 1970 to 2024 was performed.

RESULTS:

A total of 24 articles and 2 abstracts reporting 35 cases of mpox keratitis were identified. A frequency of 0.5% to 1.0% may be the lower range of mpox keratitis among symptomatic patients with a confirmed mpox diagnosis. Mpox keratitis occurred with and without systemic mpox. Initial misdiagnoses were common (40%). Polymerase chain reaction results aided clinical diagnosis. Corneal disease ranged from mild epitheliopathy to fulminant ulcerative keratitis. Outcomes ranged from 20/20 acuity to no light perception. In the absence of fulminant systemic disease, tecovirimat was associated with clinical improvement of mpox keratitis in almost all cases. Our case is the only known report of successful penetrating keratoplasty for mpox keratitis and the only case whereby monkeypox virus was cultured from the corneal surface.

CONCLUSIONS:

Mpox keratitis is rare but can result in severe vision loss and blindness. Systemic tecovirimat seems to be effective in treating mpox keratitis, although the low frequency of keratitis precludes clinical trials. Topical steroids may extend virus survival in the cornea. Polymerase chain reaction may help confirm mpox corneal involvement.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Virales del Ojo / Queratoplastia Penetrante Límite: Humans Idioma: En Revista: Cornea Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Virales del Ojo / Queratoplastia Penetrante Límite: Humans Idioma: En Revista: Cornea Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos