Diagnostic Role of Anterior Segment Optical Coherence Tomography in an Atypical Presentation of Varicella Zoster Virus Interstitial Keratitis: A Case Report
February 2026
in “
American Journal of Case Reports
”
Studysummary This case report describes a 26-year-old woman with an uncommon presentation of varicella zoster virus interstitial keratitis misdiagnosed as corneal intraepithelial neoplasia; the correct identification using diagnostic tools such as AS-OCT prevented unnecessary surgical interventions and allowed for effective antiviral treatment.
Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer
This case report discusses a 26-year-old woman with an atypical presentation of varicella zoster virus (VZV) interstitial keratitis, initially suspected to be corneal intraepithelial neoplasia (CIN). The patient experienced symptoms including unilateral headache, alopecia, loss of eyelashes, and redness over 5 years. Anterior segment optical coherence tomography (AS-OCT) and epithelial mapping were crucial in diagnosing VZV interstitial keratitis, distinguishing it from CIN. Treatment with oral valacyclovir and topical corticosteroids resolved the keratitis within 1 month, leaving residual scarring. The report emphasizes the importance of considering infectious causes in atypical corneal lesions and the diagnostic value of AS-OCT in preventing unnecessary surgical interventions.
