A stepping stone in treating dendritic keratitis

Abstract

Purpose: To report the outcome of self-retained amniotic membrane after debridement in recurrent dendritic keratitis.

Observations: A 70-year-old female with a recurrent dendritic corneal ulcer received debridement followed by placement of self-retained amniotic membrane. Five days after treatment, the patient experienced a complete resolution of symptoms, marked reduction of inflammation, complete re-epithelialization of the cornea and improvement of visual acuity. The corneal surface remained stable for 18 months despite noncompliance in using antiviral therapy.

Conclusions and importance: Self-retained amniotic membrane after debridement appears effective in treating dendritic keratitis. While early debridement is crucial to remove the infected corneal epithelium, amniotic membrane was shown to enhance the healing without scarring or recurrence. Besides the known anti-inflammatory and anti-scarring effects of the amniotic membrane, it may have a potential topical antiviral effect that warrants further investigation.

Keywords: Amniotic membrane; Antiviral; Dendritic keratitis; Interferon.

Fig. 1

Treatment of acute dendritic keratitis. Recurrent dendritic corneal ulcer (Top), treated with self-retained cryopreserved amniotic membrane after debridement (Middle), complete epithelization was achieved within 5 days and remained stable without recurrence (Bottom).