单纯疱疹性角膜炎:临床概述

Mutali Musa, Ehimare Enaholo, Gladness Aluyi-Osa, George Nnamdi Atuanya, Leopoldo Spadea, Carlo Salati, Marco Zeppieri
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引用次数: 0

摘要

我们的小视角旨在简要概述单纯疱疹性角膜炎(HSK)的诊断、临床表现、治疗方案、管理和现有文献。这种角膜病毒感染是由单纯疱疹病毒(HSV)引起的,可影响包括角膜在内的多种组织。HSK 的一个显著特点是它可能导致角膜炎症和损伤的反复发作。初次感染后,HSV 可在三叉神经节(眼睛附近的神经簇)中形成潜伏感染。病毒可能长期处于休眠状态。病毒会定期重新激活,导致 HSK 反复发作。引发病毒再激活的因素包括压力、疾病、免疫抑制或外伤。复发可表现为不同的临床模式,从轻微的上皮受累到较严重的基质或内皮病变。复发的严重程度和频率因人而异。严重的 HSK 病例,尤其是涉及基质并导致瘢痕形成的病例,可导致视力受损,极端病例甚至失明。角膜的清晰度对良好的视力至关重要,而瘢痕会损害角膜的清晰度,从而可能导致视力障碍。HSK的治疗不仅包括治疗急性发作,还包括实施长期策略以防止复发,并尝试通过神经化修复角膜神经末梢。抗病毒药物,如口服阿昔洛韦或外用更昔洛韦,可用于预防。对病毒的免疫反应会造成角膜损伤。机体试图控制感染而引起的炎症可能会无意中伤害角膜组织。临床医生应了解病毒的诱发因素,并建议采取相应措施将病毒再激活的风险降至最低。总之,HSK 的复发性强调了急性和长期管理策略对保护角膜健康和维持最佳视觉功能的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Herpes simplex keratitis: A brief clinical overview.

The aim of our minireview is to provide a brief overview of the diagnosis, clinical aspects, treatment options, management, and current literature available regarding herpes simplex keratitis (HSK). This type of corneal viral infection is caused by the herpes simplex virus (HSV), which can affect several tissues, including the cornea. One significant aspect of HSK is its potential to cause recurrent episodes of inflammation and damage to the cornea. After the initial infection, the HSV can establish a latent infection in the trigeminal ganglion, a nerve cluster near the eye. The virus may remain dormant for extended periods. Periodic reactivation of the virus can occur, leading to recurrent episodes of HSK. Factors triggering reactivation include stress, illness, immunosuppression, or trauma. Recurrent episodes can manifest in different clinical patterns, ranging from mild epithelial involvement to more severe stromal or endothelial disease. The severity and frequency of recurrences vary among individuals. Severe cases of HSK, especially those involving the stroma and leading to scarring, can result in vision impairment or even blindness in extreme cases. The cornea's clarity is crucial for good vision, and scarring can compromise this, potentially leading to visual impairment. The management of HSK involves not only treating acute episodes but also implementing long-term strategies to prevent recurrences and attempt repairs of corneal nerve endings via neurotization. Antiviral medications, such as oral Acyclovir or topical Ganciclovir, may be prescribed for prophylaxis. The immune response to the virus can contribute to corneal damage. Inflammation, caused by the body's attempt to control the infection, may inadvertently harm the corneal tissues. Clinicians should be informed about triggers and advised on measures to minimize the risk of reactivation. In summary, the recurrent nature of HSK underscores the importance of both acute and long-term management strategies to preserve corneal health and maintain optimal visual function.

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