Epstein-Barr Virus Corneal Endotheliitis and Uveitis in a Patient With Extranodal Natural Killer/T-Cell Lymphoma

Abstract

Purpose:To report a case of Epstein-Barr virus (EBV) corneal endotheliitis and uveitis in a patient diagnosed with extranodal natural killer/T-cell lymphoma (ENKTL).Methods:This is a case report performed at a tertiary care center in the Republic of Korea.Results:A 64-year-old man presented with decreased vision in his right eye that had persisted for 4 days. Best-corrected visual acuity was finger counting at 50 cm in the right eye and 0.8 in the left eye. Intraocular pressure was within the normal range in both eyes. Slit-lamp examination revealed scattered keratic precipitations and diffuse corneal edema in the right eye. Because of the severe edema, anterior chamber (AC) details were obscured. In the left eye, +2 inflammatory cells were observed in the AC and +1 cells in the vitreous. A multiplex polymerase chain reaction test using aqueous humor samples from each eye yielded positive results for EBV but negative results for other herpes viruses. One week after initiating treatment with a topical acyclovir ointment, topical steroids, and oral acyclovir, corneal edema and AC inflammation improved. Subsequently, the patient was diagnosed with nasal ENKTL and underwent 3 chemotherapy cycles in the hematology-oncology department. Five months after commencing topical and oral antiviral therapies, best-corrected visual acuities improved to 0.5 in the right eye and 1.0 in the left eye.Conclusions:EBV infection can cause severe corneal edema and uveitis. In patients with ENKTL, EBV should be considered a possible etiology of ocular involvement, and timely ophthalmic management may contribute to better visual outcomes.