Transcript uveitis vs neuroptía - GEMU-SEDU

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
November 2015
Gonioscopy: open angle grade IV in
4 quadrants. No peripheral anterior
synechiaes.
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 ????