Peripheral Corneal Ulcer Revealing Viral Hepatitis C: About A Case

presenting a rare case of pheripheral cornal ulcer type mooren revealing viral hepatitis C

Ophthalmology A department, Ibn Sina hospital, Rabat, Morocco

We report the case of a 76-year-old woman, having a history of glaucoma under treatment with good therapeutic compliance, who consults for eye pain with photophobia and tearing in both eyes.

Visual acuity was 1/10 on the right and counting fingers 1 put on the left. The slit lamp examination revealed bilateral peripheral corneal ulcers, hollow and circumferential predominant on the horizontal side without interval of healthy cornea with intense conjunctival hyperaemia. A bilateral corticonuclear cataract predominant on the left with a normal fundus in the right eye, bothered by the cataract on the left.

The ulcer was treated with antibiotics but without noticeable improvement.

The assessment carried out showed a positive hepatitis C serology and an accelerated sedimentation rate. The rest of the assessment was normal.

After multidisciplinary consultation, antibiotic therapy with intensive topical corticosteroid therapy (one drop per hour) was instituted. An improvement in acuity was noted with a decrease in inflammatory signs and ulcer size. The patient was followed for 4 months with progressive reduction of corticosteroid therapy, visual acuity stabilized at 160/200 in the right eye and 40/200 in the left with complete healing of the ulcers.

The hepatitis C virus is associated with Mooren's ulcer by a mechanism of cross-immunity. The reason why patients with an immunological ulcer of the Mooren type should systematically benefit from hepatitis C serology. Control of HCV infection is necessary to obtain healing of the ulcer