Stromal microsporidial keratitis successfully treated with medical therapy

Abstract

Purpose: To report a case of severe stromal microsporidal keratitis successfully treated with oral albendazole and topical voriconazole. Observations: A 71-year-old man presented with progressive vision loss and corneal opacification for one year. Initial visual acuity was counting fingers attributed to a dense subepithelial opacification. Confocal microscopy and subsequent corneal biopsy lead to the diagnosis of microsporidial keratitis. The patient completed a four-week course of oral albendazole and topical voriconazole which resulted in resolution of the corneal opacification and improvement in visual acuity to 20/250. Conclusions and Importance: A four-week course of oral albendazole and topical voriconazole was an effective treatment for severe stromal microsporidial keratitis.

Keywords

• Microsporidia
• Stromal keratitis
• Corneal biopsy
• Confocal microscopy