Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg, Germany.
Institut für Experimentelle Ophthalmologie, Universität des Saarlandes, Homburg/Saar, Germany.
Klin Monbl Augenheilkd. 2021 Sep;238(9):989-995. doi: 10.1055/a-1306-0896. Epub 2021 Feb 19.
To assess prevalence, clinical manifestations, required keratoplasties, follow-up, and outcome in patients with Herpes Simplex Virus Keratitis (HSK) attending a University Tertiary Referral Center.
Retrospective (12 years), descriptive, observational study.
A total of 817 eyes with clinical diagnosis of HSK from 779 patients were classified by the type of presentation. We gathered data on the visual acuity, refraction, IOP, and required surgical procedures.
Stromal involvement including scars represented the most common diagnosis in our department and the main indication of penetrating keratoplasty (PKP). Epithelial keratitis (16%) presented with the best visual acuity at the first visit. Necrotizing keratitis represented 17% of the patients, 78% of whom required PKP; this group also had the worst visual acuity at first examination and was the main indication for emergency PKP. Among all eyes, 288 (35%) required PKP. A total of 230 (28%) PKPs were elective procedures and 58 (7%) PKPs were performed as emergency procedures. Two patients with quiet endothelial decompensations after recurrent HSV endotheliitis were treated with DMEK and had good visual outcomes without HSV recurrence at last follow-up.
HSK is a prevalent disease with severe consequences when not treated appropriately and on time. Even when making an accurate diagnosis, the disease can be extremely aggressive, with all the implications it brings to the patients and health system. Elective PKP had better outcomes in terms of visual acuity and clear graft percentage compared to emergency PKP.
评估在一所大学三级转诊中心就诊的单纯疱疹病毒性角膜炎（HSK）患者的患病率、临床表现、所需的角膜移植术、随访和结局。
回顾性（12 年）、描述性、观察性研究。
对 779 例患者的 817 只临床诊断为 HSK 的眼睛进行分类，根据表现类型进行分类。我们收集了视力、屈光度、眼压和所需手术程序的数据。
包括瘢痕在内的基质受累是我们科室最常见的诊断，也是穿透性角膜移植术（PKP）的主要适应证。上皮性角膜炎（16%）在首次就诊时视力最好。坏死性角膜炎占患者的 17%，其中 78%需要 PKP；该组在首次检查时视力最差，是急诊 PKP 的主要适应证。所有患者中，288 只（35%）需要 PKP。总共进行了 230 次（28%）择期 PKP 和 58 次（7%）急诊 PKP。2 例复发性单纯疱疹病毒内皮炎后安静性内皮失代偿患者接受了 DMEK 治疗，视力恢复良好，最后一次随访时无单纯疱疹病毒复发。
HSK 是一种流行疾病，如果不及时、适当治疗，后果严重。即使做出准确的诊断，疾病也可能极其严重，给患者和医疗系统带来所有的影响。与急诊 PKP 相比，择期 PKP 在视力和透明移植百分比方面的结局更好。
