Azher Tayaba N, Yin Xiao-Tang, Tajfirouz Deena, Huang Andrew Jw, Stuart Patrick M
Department of Ophthalmology, Saint Louis University.
Department of Ophthalmology and Visual Sciences, Washington University, St Louis, MO, USA.
Clin Ophthalmol. 2017 Jan 19;11:185-191. doi: 10.2147/OPTH.S80475. eCollection 2017.
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.
单纯疱疹病毒可引发多种眼部疾病，其中最常见的是疱疹性基质性角膜炎。这是一种角膜的复发性感染，通常始于角膜的亚临床感染，进而在感觉神经节（最常见的是三叉神经节）建立潜伏感染。当病毒从潜伏状态重新激活并返回角膜时，就会发生复发性感染，在角膜处重新引发炎症反应。这种炎症反应可导致角膜感觉减退、瘢痕形成和失明。将这些病变诊断为复发性单纯疱疹病毒感染的结果有时会存在问题。目前，疱疹性基质性角膜炎通过裂隙灯检查的临床表现来诊断，但文献并不总是支持这些临床发现的准确性。其他诊断测试，如聚合酶链反应测定、酶联免疫吸附测定、免疫荧光抗体和病毒培养，虽能提供更明确的诊断，但也存在一些局限性。话虽如此，准确诊断对于正确治疗是必要的，以防止严重后果。目前的治疗可减轻病变的严重程度并控制病毒的进一步传播，但无法治愈。
