光动力疗法治疗角膜新生血管后复发性单纯疱疹性角膜炎。
Recurrent herpes simplex keratitis after verteporfin photodynamic therapy for corneal neovascularization.
机构信息
Department of Ophthalmology and the Brain Korea 21 Project, Center for Biomedical Human Resources at Chonnam National University, Chonnam National University Medical School and Hospital, 8 Hak-dong, Gwangju, Korea.
出版信息
Cornea. 2010 Apr;29(4):465-7. doi: 10.1097/ICO.0b013e3181b53310.
PURPOSE
To report a case of recurrent herpes simplex keratitis after verteporfin photodynamic therapy for corneal neovascularization.
METHODS
A 69-year-old man who had lipid keratopathy with corneal neovascularization secondary to herpes simplex keratitis in the right eye and who was treated with topical steroid received photodynamic therapy with verteporfin. Six neovascular areas in the cornea were treated consecutively to occlude new vessels and reduce the risk of allograft rejection after subsequent keratoplasty.
RESULTS
Three days after verteporfin photodynamic therapy, there was evidence of vascular occlusion. However, a herpetic epithelial ulcer was detected in the cornea. Ten days after treatment, the lesion progressed to a geographic ulcer. After topical and systemic acyclovir treatment, the lesion healed. Five months after treatment, penetrating keratoplasty and postoperative antiviral prophylaxis were performed. During a follow-up period of 12 months, the graft remained clear with visual acuity of 20/40.
CONCLUSION
Herpes simplex keratitis can recur after verteporfin photodynamic therapy for corneal neovascularization.
目的
报告一例因角膜新生血管化而接受光动力疗法（verteporfin 光动力疗法）治疗后复发单纯疱疹性角膜炎的病例。
方法
一名 69 岁男性，右眼因单纯疱疹性角膜炎继发脂质性角膜病变和角膜新生血管化，曾接受局部皮质类固醇治疗，随后接受了维替泊芬光动力疗法。对角膜的 6 个新生血管区域进行连续治疗，以闭塞新血管，并降低随后行角膜移植时发生同种异体排斥的风险。
结果
维替泊芬光动力疗法后 3 天，可见血管闭塞的证据。然而，在角膜中发现了疱疹性上皮溃疡。治疗后 10 天，病变进展为地图状溃疡。经局部和全身阿昔洛韦治疗后，病变愈合。治疗后 5 个月，行穿透性角膜移植术和术后抗病毒预防。在 12 个月的随访期间，移植物保持透明，视力为 20/40。
结论
角膜新生血管化的维替泊芬光动力疗法后可复发单纯疱疹性角膜炎。
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