HSV linear endotheliitis in a post-keratoplasty patient
The present case has been reported in the journal Medicine. A 57-year-old male recently developed ocular discomfort and decreased visual acuity in his right eye. The patient had received penetrating keratoplasty in his right eye 10 years ago by another surgeon, and the exact preoperative diagnosis could not be identified.

The ocular disease was evaluated using several ocular examinations, including best-corrected visual acuity (BCVA), intraocular pressure, slit lamp examination, fundus examination, and aqueous humor tap. Characteristic linear endothelial KPs were found both in the host cornea and graft cornea. The characteristic linear keratic precipitates (KPs) resembled the Khodadoust line in graft rejection.

Stromal edema was evident in both the donor and recipient corneas. The aqueous humor was sampled for viral polymerase chain reaction (PCR) analysis. The sample was investigated for the possible presence of HSV I, HSV II, cytomegalovirus, and varicella zoster virus. The PCR was positive for HSV I and negative for HSV II, cytomegalovirus, and varicella zoster virus.

The patient was treated with both antiviral and steroid treatments for 1 month. Thereafter, prophylactic antiviral treatment was continued. The subjective symptoms had improved and the cornea edema and the linear endothelial KPs had disappeared. The BCVA improved from 20/200 to 20/80.

Lessons learnt:-
HSV linear endotheliitis is the most severe form of HSV endotheliitis. This case showed characteristic endothelial KPs, which were different from the Khodadoust line of graft rejection.

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