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Caso clínico: Varón de 62 años de edad con trasplante renal y tratamiento inmunosupresor que acude por disminución de la visión (20/100) en ojo izquierdo, edema corneal y presión intraocular de 46mmHg. Un mes después aparece queratitis dendrítica marginal inferior. El raspado corneal y la proteína C reactiva demuestran la presencia de un virus del herpes simple (HVS). Discusión: La epiteliopatía corneal autoinmunitaria o endotelitis idiopática corneal se caracteriza por edema corneal y precipitados queráticos. Se cree que el HVS podría ser secretado desde el trabeculum, inervado por el nervio trigémino, apoyado clínicamente por la progresión del edema estromal desde la periferia. Case report: A 62-year-old man with previous renal transplant and immunosuppressive treatment presented with decreased visual acuity (20/100) in his left eye, corneal oedema and intraocular pressure of 46mmHg. One month later an inferior marginal dendritic keratitis appeared. Corneal scraping and real-time polymerase chain reaction showed herpes simplex virus (HSV). Discussion: The autoimmune corneal endotheliopathy or acute idiopathic corneal endotheliitis is characterised by corneal stromal oedema and keratic precipitates. HSV might be secreted from the trabeculum, innervated by the trigeminal nerve. This hypothesis is supported by the clinical observation that the corneal stromal oedema usually starts from the periphery.

• A connatal and two adult cases of monosymptomatic endotheliitis plus trabeculitis could be correlated with culturable CMV or the presence of CMV DNA in the aqueous humor.

Diagnosis and treatment of herpes simplex virus eye diseases has benefitted from a vast amount of clinical and experimental studies. In this short presentation reference can only be made to some fields, which may illustrate--pars pro toto--the progress achieved during the last years. Clinico-virological correlation studies have led to a better understanding and classification of different typical clinical pictures, especially those affecting the structures of the anterior chamber: endotheliitis trabeculitis, and focal serous iritis. Antiherpetic drugs have become available which do not only penetrate the cornea in sufficient amounts but can also be used systemically. This will lead to a new role of steroids in the treatment of intraocular herpetic diseases. The combination of high-titer human interferon eye drops with a basic therapy of topical antiviral agents has considerably improved therapeutic results in dendritic keratitis.