Seitzman Gerami D, Strauss Erich C, Margolis Todd P
Francis I Proctor Foundation and Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA.
Cornea. 2006 Jul;25(6):742-4. doi: 10.1097/01.ico.0000214235.51732.8e.
To introduce into the clinical nomenclature a sign frequently observed in our patients with persistent corneal inflammation associated with herpetic stromal keratitis.
Case reports and review of the literature.
Four representative patients with herpesvirus stromal keratitis are presented. Herpes simplex virus-1 (HSV-1) was confirmed by culture in 1 case and by polymerase chain reaction in a second case. In the remaining 2 cases, the diagnosis was made based on characteristic clinical findings for herpes simplex virus and varicella zoster virus (VZV). On clinical examination, all 4 representative cases of stromal keratitis revealed a well-defined, localized region of intertwined, metallic-like, polychromatic material in the corneal stroma, a sign we have termed steel wool keratopathy. We have only rarely observed this finding in patients with stromal keratitis not caused by a herpesvirus.
Steel wool keratopathy seems to represent a focal region of stromal degeneration or deposition associated with chronic inflammation. Although we most often observe this finding in patients with stromal keratitis secondary to HSV or VZV, we cannot exclude the possibility that this sign represents the sequelae of chronic/recurrent inflammation rather than a specific pathologic response to herpetic antigens.
将我们在患有与疱疹性基质性角膜炎相关的持续性角膜炎症患者中经常观察到的一种体征引入临床命名法。
病例报告及文献综述。
呈现了4例疱疹病毒基质性角膜炎的代表性患者。1例通过培养确诊为单纯疱疹病毒1型（HSV-1），另1例通过聚合酶链反应确诊。其余2例根据单纯疱疹病毒和水痘带状疱疹病毒（VZV）的特征性临床表现做出诊断。临床检查时，所有4例基质性角膜炎的代表性病例在角膜基质中均显示出一个界限清晰、局部的、交织的、类似金属的多色物质区域，我们将此体征称为钢丝绒角膜病变。我们在非疱疹病毒引起的基质性角膜炎患者中很少观察到这一发现。
钢丝绒角膜病变似乎代表与慢性炎症相关的基质变性或沉积的局灶区域。尽管我们最常在继发于HSV或VZV的基质性角膜炎患者中观察到这一发现，但我们不能排除该体征代表慢性/复发性炎症的后遗症而非对疱疹抗原的特异性病理反应的可能性。
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