Purpose: To report the management of a patient with chronic herpes zoster ophthalmicus with previously undiagnosed natural killer cell deficiency.
Methods: A 50-year-old female presented with herpes zoster ophthalmicus that despite appropriate treatment progressed to uveitis and expansion of the lesions. Multiple attempts to wean the patient off therapeutic anti-viral medications continued to result in reoccurrence of the disease. Discovery of underlying natural killer cell deficiency prompted indefinite treatment with therapeutic anti-viral medication.
Results: After multiple flares of herpes zoster ophthalmicus over 3 years, seven prior to the discovery of the immunodeficiency, she developed unilateral corneal scarring on the affected side. At this time, her visual acuity was measured to be uncorrected at 20/150 with improvement to 20/25-1 with refraction.
Conclusions: This case highlights the need for further immunological investigation and unconventional medical management with recurrent viral infections to prevent visual morbidity.
【저자키워드】 immunodeficiency, natural killer cell, Herpes Zoster Ophthalmicus, Uveitis, viral keratitis.,