University of California, Davis, UC Davis Eye Center Sacramento, California, USA.
Curr Opin Ophthalmol. 2018 Jul;29(4):328-333. doi: 10.1097/ICU.0000000000000491.
Herpes zoster is a common condition, and involvement of the trigeminal nerve results in herpes zoster ophthalmicus (HZO). Acute keratitis is one of the most common of these ocular complications associated with HZO. The findings associated with and the management of acute zoster keratitis will be reviewed.
The incidence rate of herpes zoster has been on the rise over the past several decades. At the same time, the average patient age at presentation is declining with similar trends also seen in HZO. The cause of these changes has yet to be determined. Our understanding of corneal involvement in HZO continues to evolve with new imaging demonstrating viral particles within keratocytes in a case of zoster stromal keratitis. New medications such as topical ganciclovir are also helping to better manage acute zoster keratitis that is unresponsive to oral antiviral therapy.
Acute zoster keratitis can lead to permanent vision loss. Early diagnosis and management may help reduce these potentially devastating complications. Oral and topical antiviral medications can play a role in managing the acute disease, and herpes zoster vaccinations are important for prevention of disease. Further research must be done to establish standards for treatment of anterior segment complications from herpes zoster.
带状疱疹是一种常见疾病，累及三叉神经可导致带状疱疹性眼病（HZO）。急性角膜炎是 HZO 最常见的眼部并发症之一。本文将对急性带状疱疹性角膜炎的相关表现和治疗进行综述。
过去几十年带状疱疹的发病率一直在上升。与此同时，就诊患者的平均年龄呈下降趋势，HZO 也呈现出类似的趋势。这些变化的原因尚未确定。我们对 HZO 中角膜受累的认识仍在不断发展，新的影像学研究显示一例带状疱疹基质性角膜炎中角膜基质细胞内存在病毒颗粒。新的药物，如更昔洛韦滴眼液，也有助于更好地管理对口服抗病毒治疗无反应的急性带状疱疹性角膜炎。
急性带状疱疹性角膜炎可导致永久性视力丧失。早期诊断和治疗可能有助于减少这些潜在的破坏性并发症。口服和局部抗病毒药物可在治疗急性疾病中发挥作用，带状疱疹疫苗对预防疾病也很重要。必须进一步研究，以制定治疗带状疱疹前节并发症的标准。
