Preliminary clinical report of alternate episodes of Posner–Schlossman syndrome and viral keratitis

• Published in: Transplant immunology 2022-10, Vol.74, p.101673-101673, Article 101673
• Main Authors: Sun, Zhong, Cao, Dan-Min, Zhang, Yin, Zhou, He-Zheng
• Format: Article
• Language: English
• Subjects: Alternating episode; Posner–Schlossman syndrome; Viral keratitis
• ISSN: 0966-3274; 1878-5492
• DOI: 10.1016/j.trim.2022.101673

Posner–Schlossman syndrome (PSS) and viral keratitis have a shared pathogen and are common diseases in China, but there are few case reports on whether these two diseases occur concurrently or alternately. After long-term clinical observations, six patients with alternating episodes of PSS and viral keratitis were confirmed at our hospital in the past 10 years. Of the six patients, three were female and three were male. Four patients had monocular PSS with ipsilateral monocular viral keratitis, one had monocular PSS with bilateral viral keratitis, and one had bilateral PSS with bilateral viral keratitis. Of the six cases, three had epithelial viral keratitis and three had endothelial viral keratitis. In four cases, the interval between the onset of the two diseases ranged from 8 days to 3 years, and two cases showed overlapping manifestations of the two diseases in 3 to 6 days, both with incomplete absorption of keratic precipitates. The six cases had intermittent episodes of both diseases and significant loss of corneal sensation during the onset of viral keratitis, and were effectively treated with antiviral therapy. PSS and viral keratitis may alternate episodically, and clinical attention should be paid to these conditions. The mechanism of the alternate episodes might be associated with viral infection and the use of glucocorticoids. •The common features of PSS and viral keratitis are that both diseases are prone to recurrent episodes with variable intervals.•For patients with PSS, the condition of the cornea and related symptoms should be observed for the rapid detection and treatment of alternating viral keratitis.•After viral keratitis has been clinically cured, KPs and IOP should be regularly monitored for the timely detection and treatment of PSS.