Department of Ophthalmology, Peking University Third Hospital, Beijing, China.
Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, P. R. China.
Ocul Immunol Inflamm. 2019;27(8):1270-1279. doi: 10.1080/09273948.2018.1521435. Epub 2018 Sep 25.
: To explore the clinical characteristics and confocal microscopic (IVCM) findings of varicella zoster virus (VZV)-related corneal endotheliitis.: Retrospectively reviewed 20 eyes with corneal edema which were diagnosed by real-time polymerase chain reaction.: one had VZV infection. Three had epithelial lesions. Six had mydriasis. Four had loss of iris pigment. Keratic precipitates (KPs) were mixed. Subbasal nerves had disappeared in 12 eyes. Langerhans cells were observed in seven eyes. The deviations in endothelial cell layers consisted of guttate ( = 1), enlarged intercellular gaps ( = 11), infiltration of inflammatory cells ( = 8), loss of defined cell boundaries ( = 1) and anomalous nucleus ( = 9). The shape of KPs in IVCM included type I ( = 6), type III ( = 3) and type IV ( = 4).Conclusion: VZV-related corneal endotheliitis is remarkably difficult to detect clinically. Most cases have no typical skin lesions. The typical clinical feature is that of segmental iris atrophy and mixed KPs.
: 探讨单纯疱疹病毒（VZV）相关性角膜内皮炎的临床特征和共焦显微镜（IVCM）表现。: 回顾性分析 20 例经实时聚合酶链反应诊断为角膜水肿的患者，其中 1 例为 VZV 感染。3 例有上皮病变。6 例瞳孔散大。4 例虹膜色素丧失。KP 混合存在。12 眼基底神经消失。7 眼可见朗格汉斯细胞。内皮细胞层的病变包括点状（=1）、细胞间间隙增大（=11）、炎症细胞浸润（=8）、细胞边界不清（=1）和异常核（=9）。IVCM 中 KP 的形态包括 I 型（=6）、III 型（=3）和 IV 型（=4）。结论：VZV 相关性角膜内皮炎临床上很难发现，多数患者无典型皮肤病变，典型的临床特征是节段性虹膜萎缩和混合 KP。
