Linear Interstitial Keratitis
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Disease Entity
Linear Interstitial Keratitis (LIK) is a rare linear stromal lesion of the cornea that has been reported in young adults as early as 1923 [1].
Disease
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Etiology
Once postulated to be spurred by syphilitic infection, we now know from case reports that anti-treponemal antibodies are generally absent, suggesting positive serology as an incidental finding [1]. The etiology remains unknown, and histology from perforated corneas with LIK undergoing patch grafting has proven unrevealing [1].
General Pathology
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Pathophysiology
Syphilis and Lyme were once implicated in the etiology of this condition, but serologies in patients with LIK have been equivocal without clear positivity across all case reports [1, 3, 4]. Petrovic et al suggest that this condition derives from autoimmunity.
Diagnosis
Diagnosis is clinical based on the linear appearance of the opacity and its response to steroid therapy. Laboratory serologies for Lyme and Syphilis may
History
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Physical examination
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Signs
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Symptoms
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Clinical diagnosis
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Diagnostic procedures
Diagnosis is clinical based on the linear appearance of the corneal opacity
Differential diagnosis
Interstitial keratitis
Herpes disciform endotheliitis
Herpes necrotizing keratitis
Bacterial keratitis
Fungal keratitis
Acanthamoeba
Neurotrophic keratitis,
Management
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General treatment
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Medical therapy
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Medical follow up
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Surgery
Penetrating keratoplasty may be performed for perforation, but surgery is not typically recommended.
Surgical follow up
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Complications
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Prognosis
The prognosis for recovery with steroid use appears to be good; however, inflammation tends to recur.
References
1. Calvo, C.M., et al., Linear interstitial keratitis: a distinct clinical entity revisited. Cornea, 2012. 31(12): p. 1500-3.
2. Rapuano, C., Cornea : Cornea. 2018, Philadelphia, Untied States: Wolters Kluwer.
3. Petrovic, A., et al., Characteristics of Linear Interstitial Keratitis by In Vivo Confocal Microscopy and Anterior Segment Optical Coherence Tomography. Cornea, 2018. 37(6): p. 785-788.
4. Direev, A.O. and V.V. Chernykh, A clinical case of linear stromal (interstitial) keratitis. Acta biomedica scientifica, 2022. 7(4): p. 88-94.
- ↑ Illinois Eye and Ear Infirmary, shared with patient guardian permission
