Herpes simplex keratitis: challenges in diagnosis and clinical management.
Herpes simplex keratitis: challenges in diagnosis and clinical management.
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单纯疱疹性角膜炎：诊断和临床管理方面的挑战。
DOI：
10.2147/opth.s80475
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Stuart PM
中科院分区：
文献类型：
--
作者：
Azher TN;Yin XT;Tajfirouz D;Huang AJ;Stuart PM
单纯疱疹病毒可导致多种眼部疾病，其中最常见的是疱疹间质性角膜炎。这是一种复发性角膜感染，通常始于角膜的亚临床感染，建立感觉神经节的潜伏性感染，最常见的是三叉神经节。当病毒从潜伏期重新激活并返回角膜时，就会发生反复感染，在那里它会重新刺激炎症反应。这种炎症反应会导致角膜知觉减弱、结疤和失明。单纯疱疹病毒反复感染导致这些病变的诊断有时是有问题的。目前，单纯疱疹间质性角膜炎是通过裂隙灯检查的临床表现来诊断的，但文献并不总是支持这些临床结果的准确性。其他诊断试验，如聚合酶链式反应试验、酶联免疫吸附试验、免疫荧光抗体和病毒培养，提供了更明确的诊断，但也有一定的局限性。也就是说，准确的诊断对于适当的治疗是必要的，以防止严重的后果。目前的治疗方法降低了病变的严重程度，并控制了病毒的进一步传播，但不能提供治愈方法。
Herpes simplex virus is responsible for numerous ocular diseases, the most common of which is herpetic stromal keratitis. This is a recurrent infection of the cornea that typically begins with a subclinical infection of the cornea that establishes a latent infection of sensory ganglia, most often the trigeminal ganglia. Recurring infections occur when the virus is reactivated from latency and travels back to the cornea, where it restimulates an inflammatory response. This inflammatory response can lead to decreased corneal sensation, scarring, and blindness. The diagnosis of these lesions as the result of a recurrent herpes simplex virus infection can at times be problematic. Currently, herpetic stromal keratitis is diagnosed by its clinical presentation on the slit-lamp examination, but the literature does not always support the accuracy of these clinical findings. Other diagnostic tests such as polymerase chain reaction assay, enzyme-linked immunosorbent assay, immunofluorescent antibody, and viral cultures have provided more definitive diagnosis, but also have some limitations. That said, accurate diagnosis is necessary for proper treatment, in order to prevent serious consequences. Current treatment reduces the severity of lesions and controls further viral spread, but does not provide a cure.