재발성 각막미란 환자에서 뚜렷한 각막침윤 없이 생긴 전방염증 및 황반부종 1예

Hypopyon and Cystoid Macular Edema without Corneal Infiltration in Recurrent Corneal Erosion

Purpose: We introduce a case of severe anterior chamber reaction without definite corneal infiltration and cystoid macular edema associated with recurrent corneal erosion. Case summary: An 82-year-old woman visited our clinic with blurred vision and ocular pain in her left eye. She had been suffering from Sjogen disease and keratoconjunctivitis sicca for 8 years. She had been treated for recurrent corneal erosion and filamentary keratitis with bandage contact lens and topical lubrication. Slit lamp examination revealed severe anterior chamber reaction with hypopyon and corneal epithelial defect without infiltration. No organism was found in aqueous humor culture. She was treated with bandage contact lenses, topical antibiotics and steroids, and her symptoms were improved. After 18 days, cystoid macular edema developed in her left eye. Macular edema was decreased after intravitreal bevacizumab injection. Conclusions: Recurrent corneal erosion might be accompanied by severe anterior chamber reaction with hypopyon without definite corneal infiltration. This sterile inflammation can be relieved by topical antibiotics and steroids. This also harbors the risk of secondary macular edema, which can be treated with intravitreal anti-vascular endothelial growth factor injection.