Mooren-type Hepatitis C Virus-associated Corneal Ulceration

S. E. Wilson, W. M. Lee, C. Murakami, J. Weng, G. A. Moninger

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Abstract

Background: Two patients with bilateral Mooren-type ulcers had underlying chronic hepatitis C virus (HCV) infection. Both patients also had chronic, pruritic dermatitis, which in one patient was diagnosed as hidradentitis suppurativa. Methods: Serum from the first patient and serum, conjunctiva, and liver from the second patient were analyzed for HCV genomic RNA using the reverse transcriptasepolymerase chain reaction. Serum anti-HCV antibodies were monitored with a commercially available second-generation test. Liver and conjunctival biopsies were evaluated histopathologically. Results: Liver biopsy showed severe hepatitis in the first patient, but normal liver tissue in the second. Hepatitis C virus genomic RNA was detected in the serum of both patients. In the first patient, the virus was detected 4 months after completion of interferon alfa-2b treatment for chronic active hepatitis. In the second patient, HCV genomic RNA was detected in serum, but not in conjunctiva or liver tissue. Hepatitis C virus could not be detected in the serum of the second patient after 2 weeks of interferon alfa-2b treatment. Both patients had serum anti-HCV antibodies. In case 1, there was a marked improvement in the corneal disease during and after 6 months of interferon alfa-2b treatment for chronic active hepatitis that paralleled a return of serum liver enzyme levels to the normal range. In the second patient, the corneal disease improved after 6 weeks of interferon alfa-2b treatment, but abruptly worsened when the patient discontinued therapy. The corneal disease improved again after interferon alfa-2b was reinstituted. Conclusions: Chronic HCV virus infection is associated with Mooren-type peripheral ulcerative keratitis. All patients with Mooren-type ulcers should be tested for evidence of HCV infection in consultation with a liver specialist. Even when improvement is obtained with interferon alfa-2b treatment, however, continued follow-up is important because relapse is common and repeat treatment may be effective.

Original languageEnglish (US)
Pages (from-to)736-745
Number of pages10
JournalOphthalmology
Volume101
Issue number4
DOIs
StatePublished - Jan 1 1994

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ASJC Scopus subject areas

  • Ophthalmology

Cite this

Wilson, S. E., Lee, W. M., Murakami, C., Weng, J., & Moninger, G. A. (1994). Mooren-type Hepatitis C Virus-associated Corneal Ulceration. Ophthalmology, 101(4), 736-745. https://doi.org/10.1016/S0161-6420(94)31291-7