PMC8131066_01
Right eye of a 56-year-old patient with dendritic epithelial keratitis during the follow-up period ((A): baseline; (B): after 3 days; (C): after 4 days; (D): after 7 days).
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The slit lamp examination revealed slight lid oedema and conjunctival hyperaemia; and the fluorescein stain test revealed branching epithelial lesions with terminal bulbs consistent with the situation that is classically observed with herpes simplex virus (HSV) epithelial keratitis (shown in Figure 1A). Three days later, a decrease in the fluorescent area and dendritic thickness (Figure 1B), accompanied by a reduction in pain, lacrimation and photophobia was observed. By day four, the corneal involvement and fluorescein staining were practically resolved (Figure 1C), and a further reduction in symptoms occurred. After one week of treatment, the corneal examination showed good healing of the defect (Figure 1D), and a full recovery of visual acuity in right eye was achieved.
PMC8131066_02
A 65-year-old man immediately after a corneal trauma caused by an olive leaf ((A): Large inferior trauma between 2 and 6 o'clock; (B): after 2 days; (C): after 3 days of treatment).
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The slit lamp examination revealed upper lid oedema, conjunctival redness, and a large corneal abrasion involving the nasal and lower-nasal zones of the cornea (from 2 to 6 o'clock on the fluorescein eye stain test) (Figure 2A). Two days later, the abrasion had shrunk by about 50% (Figure 2B), with a partial resolution of the sub-oedema, and a reduction in corneal staining. Three days later, the corneal epithelium had healed completely (Figure 2C), BCVA had reached 10/10, and the symptoms had completely resolved.
PMC8131066_03
Corneal abscess in a 63-year-old woman ((A): slit lamp; (B): corneal OCT; (C): after 3 days; (D): after 5 days; (E): corneal confocal microscopy after 5 days; (F): corneal abscess nearly solved after 7 days; (G): after 10 days; (H): after 12 days; (I-K): the OCT examination shows a gradual and progressive normalisation of corneal anatomy, with resolution of the abscess area and the ulcer).
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She also presented severe corneal infection, corneal abscess, and corneal oedema with Descemet's folds (Figure 3A). Anterior segment OCT images revealed hyper-reflectivity with high scattering effect due to a dense accumulation of abscess material and an increased corneal thickness (Figure 3B). After 3 days of treatment, the objective clinical situation showed an initial improvement, with a reduction of abscess area, corneal oedema and corneal infection (Figure 3C). After 5 days, a further improvement was seen, and initial draining of the abscess was performed (Figure 3D). The confocal microscopy revealed the presence of severe inflammatory cell infiltrate, which almost completely replaced the keratocytes, caused by the viral agent (Figure 3E). Therapy with liposomal ozonated oil (3 times a day) was continued, and after 7 days, a significant reduction was seen in the affected area on the fluorescein test (Figure 3F). Ten days later, restoration of epithelial integrity was observed (Figure 3G and H) with a slight positive fluorescein test. The OCT showed a gradual and progressive normalisation of corneal anatomy, with resolution of the abscess area and ulcer (Figure 3I, L and M).