Recurrent peripheral corneal ulcers and detection of hepatitis C virus RNAin lacrimal fluid - a case report

Background: There are conflicting reports on the role of hepatitis C virus in corneal pathology. Patient: A 58-year-old male patient presented with recurrent peripheral cor neal ulcers and corneal thinning in the left eye. There was a bilateral vas cular pannus formation and a decreased ocular wetting measured by Schirmer testing. The posterior ocular segment was normal. There was no sign of any systemic rheumatic disease. Serological testing detected antibodies against hepatitis C virus. Hepatitis C virus RNA testing using a quantitative poly merase chain reaction method revealed hepatitis C virus RNA in serum (>3.2 million copies/ml) and in tear samples (18000 copies/ml) of the patient. In a control group of 7 consecutive patients with hepatitis C virus RNA detec tion in the serum but without ocular pathology, no hepatitis C virus RNA wa s detected in tear samples (detection limit: 1000 copies/ml). Conclusions: Detection of hepatitis C virus RNA in lacrimal fluid of a pati ent with recurrent peripheral corneal ulcers may indicate a pathogenic role of hepatitis C virus in corneal pathology. Especially, since our patients with systemic hepatitis C virus infection but without ocular changes did no t show hepatitis C virus RNA in their tears. Therefore, patients with recur rent corneal ulcers elf unknown origin should be tested for systemic hepati tis C virus infection.