PURPOSE: Epidemic keratoconjunctivitis (EKC) is a highly contagious infection caused by adenovirus types 8, 19, and 37. The formation of subepithelial nummular infiltrates may lead to permanent visual disturbance. These infiltrates consist histopathologically of an accumulation of lymphocytes, histiocytes, and fibroblasts. PATIENT AND METHOD: The reasons for the persistence of these nummular infiltrates are not fully understood. We examined a 28-year-old female patient with typical signs of EKC infection clinically and additionally with the RLSM. RESULTS: Nummuli were identified by the RLSM as areas with an accumulation of dendritic cells (supposed to be Langerhans cells) as well as so far unidentified punctiform structures located in the basal cell layer and in the region of the subepithelial nerve plexus. CONCLUSIONS: The RLSM allows us to investigate corneal microstructures in vivo with precise depth localization related to epidemic keratoconjunctivitis. Further investigations may disclose the role of dendritic cells in the pathogenesis of the nummular formation as well as their contribution to the variable persistence of partially threatening vision opacities.
PURPOSE:Epidemic keratoconjunctivitis (EKC) is a highly contagious infection caused by adenovirus types 8, 19, and 37. The formation of subepithelial nummular infiltrates may lead to permanent visual disturbance. These infiltrates consist histopathologically of an accumulation of lymphocytes, histiocytes, and fibroblasts. PATIENT AND METHOD: The reasons for the persistence of these nummular infiltrates are not fully understood. We examined a 28-year-old female patient with typical signs of EKC infection clinically and additionally with the RLSM. RESULTS: Nummuli were identified by the RLSM as areas with an accumulation of dendritic cells (supposed to be Langerhans cells) as well as so far unidentified punctiform structures located in the basal cell layer and in the region of the subepithelial nerve plexus. CONCLUSIONS: The RLSM allows us to investigate corneal microstructures in vivo with precise depth localization related to epidemic keratoconjunctivitis. Further investigations may disclose the role of dendritic cells in the pathogenesis of the nummular formation as well as their contribution to the variable persistence of partially threatening vision opacities.
Authors: Katharina A Sterenczak; Nadine Stache; Sebastian Bohn; Stephan Allgeier; Bernd Köhler; Andreas Bartschat; Christian George; Rudolf F Guthoff; Oliver Stachs; Angrit Stachs Journal: Diagnostics (Basel) Date: 2021-05-07