摘要
病毒性角膜内皮炎并不少见,但因对其临床表现认识不足,误诊、漏诊病例屡见不鲜。角膜内皮炎常由单纯疱疹病毒、带状疱疹病毒感染所致。临床分为三种类型:盘状角膜内皮炎、弥漫性角膜内皮炎和线状角膜内皮炎。临床表现为病变部位角膜水肿,水肿部位羊脂状KP,当合并小梁网炎时伴有眼压升高,临床上常与青光眼-睫状体炎综合征相混淆。治疗关键点是抗病毒和抗炎,正确合理地使用抗病毒药和皮质类固醇激素类药物非常重要。用药的方法分为全身用药和局部用药。大部分患者眼局部用药是主要的给药途径,对于部分反复发作和病情严重的患者可考虑全身给药。皮质类固醇激素应用的浓度和频度要根据患者的病情而定,但基本原则是在足量应用全身和局部抗病毒药的基础上选择生物利用率高的皮质类固醇激素,将炎症迅速控制后逐渐减量,缓慢停药。
Viral cornea endotheliitis is not uncommon, but misdiagnosis and missed diagnosis are often seen in clinic, and leading to serious results due to lack of knowledge. Cornea endotheliitis is mainly caused by simplex virus （HSV） or varieella zoster virus （VZV） infection. It can be classified clinically into three forms： linear, disciform, and diffuse. The main manifestation is corneal edema associated with mutton-fat keratic precipitates. When an elevated IOP is accompanied as a result of combined trabecular meshwork inflammation, corneal endotheliitis can be misdiagnosed of glaucomatocyclitis. The two key points of treatment are anti-virus and anti- inflammation. It is important to apply antiviral agents and cortical steroids appropriately. The administration route can be systematic and local. For most patients, local medication is the main route, but for those with recurrent lesion and severe inflammation, systemic appli- cation should be considered. The concentration and frequency of cortical steroids should be decided based on patient＇s condition indi- vidually. However, the principle is to apply cortical steroids of high bioavailability based on sufficient antiviral agent systematically and locally. It is very important to control inflammation rapidly, taper steroids gradually, and cease them slowly.
出处
《眼科》
CAS
2010年第3期158-160,共3页
Ophthalmology in China
关键词
角膜内皮炎
诊断
治疗
endotheliitis
diagnosis
treatment
