Borja Maroto Rodríguez Esther Corredera Salinero

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Presentation transcript:

CHRONIC ANTERIOR HYPERTENSIVE UVEITIS ASSOCIATED WITH EPSTEIN BARR VIRUS AND OPTIC NEUROPATHY Borja Maroto Rodríguez Esther Corredera Salinero Óscar Gutierrez Montero Fredy Ruiz Aimituma Hospital Universitario de Fuenlabrada (Madrid)

A 53 years old women with a history of: - Amblyopic right eye (light percepción). - Arterial hypertension, dyslipidemia, smoker. - 5 abortions without etiology. Since 2009 chronic anterior hypertensive uveítis in both eyes (especially left eye). VA 0,7-0,8

Topical treatment: CORTICOSTEROIDS AND OCULAR HIPOTENSIVE. Exclusion of other pathologies for uveítis. 2013: PCR of aqueous humor was positive for Epstein Barr Virus (EBV) in two samples. VALACYCLOVIR. Various unsuccessfully immunomodulating: methotrexate, salazopyridazina, adalimumab 2015: AZATHIOPRINE + INFLIXIMAB. Some clinical improvement without complete resolution of inflammation.

Last year presents loss of peripheral vision April 2015 Gonioscopy: open angle grade IV in 4 quadrants. No peripheral anterior synechiaes. November 2015

Optic nerve evoked potentials: Asymmetry Optic nerve evoked potentials: Asymmetry. Significant delay in the potential of the left side with respect to the right Chronic hypertensive Uveitis secondary to EBV infection ??? Retrobulbar neuropathy secondary to EBV infection ??? Retrobulbar neuropathy secondary to Infliximab treatment ???? Glaucomatous neuropathy secondary to chronic hypertensive uveítis ????