Abstract
Purpose :
The Epstein–Barr virus (EBV) is a double-stranded DNA virus from the Herpesviridae family and infects more than 90% of people worldwide, but ocular infections related to EBV are less commonly reported. This study aimed to identify the characteristics of the patients with EBV ocular infection, and to investigate the response to different antiviral treatment modalities.
Methods :
Patients with EBV ocular infections in a tertiary referral hospital in Taiwan between 2011 and 2022 were included. Diagnoses were confirmed by the detection of EBV DNA in the aqueous humor or vitreous by PCR assay. Patients with corneal epithelial or stromal scars, previous ocular herpes infection, and coinfection with other pathogens were excluded. Medical records were retrospectively reviewed for infection duration, medical and ocular history, visual acuity, intraocular pressure (IOP), ocular findings, diagnosis, and treatment.
Results :
In total, there were 29 eyes from 29 patients, including 21 men and 8 women. The mean age was 57.9 years (range, 34–92 years). The mean follow-up time was 31.7 months (range, 1–84 months). Anterior segment infection presented with keratic precipitates, corneal edema and anterior chamber inflammation was the most common diagnosis (65.5%, 19 of 29 patients). Four patients had prior corneal transplantation. Fourteen patients had initial visual acuity less than 0.01. Ten of the 29 eyes had elevated IOP. Oral valganciclovir was prescribed in 7 patients, and 11 patients received famciclovir. Others were treated with topical ganciclovir. Except for 2 eyes, IOP normalized without medications in all cases. The final vision was improved in 14 patients.
Conclusions :
Epstein-Barr virus can be present solely as an ocular pathogen, with anterior segment infection being the most frequent diagnosis. Viral PCR is an effective tool for detecting ocular infection. Appropriate antiviral treatment, including acyclovir and ganciclovir, can aid in vision improvement and prevent further ocular damage.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.