Sado K, Kimura T, Hotta Y, Sakuma H, Hayakawa M, Kato K, Kanai A
Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan.
Retina. 1994;14(3):260-3. doi: 10.1097/00006982-199414030-00013.
Although acute retinal necrosis (ARN) syndrome is caused by a herpes group virus, association of herpetic keratitis with ARN syndrome is uncommon. A case of unilateral ARN syndrome with herpes simplex keratitis is discussed.
A 40-year-old man developed unilateral keratitis, necrotic retinitis, retinal vasculitis, vitritis, and iritis consistent with ARN syndrome 1 month after treatment for ipsilateral facial nerve palsy and auricular herpetic vesicles (Tolosa-Hunt syndrome). Impression cytologic examination of the corneal epithelial ulcer that developed concurrent with the intraocular findings and of the aqueous humor (obtained by paracentesis) was performed.
Cells that reacted with anti-herpes simplex virus type 1 (HSV-1) antibody were detected on impression cytology, and DNA fragments corresponding to the HSV-1 DNA sequence were detected in the aqueous humor.
This case shows that ARN syndrome may, on rare occasions, be associated with herpes keratitis secondary to HSV-1.
虽然急性视网膜坏死(ARN)综合征由疱疹病毒组病毒引起,但疱疹性角膜炎与ARN综合征的关联并不常见。本文讨论了1例伴有单纯疱疹性角膜炎的单侧ARN综合征病例。
一名40岁男性在同侧面神经麻痹和耳疱疹性水疱(托洛萨-亨特综合征)治疗1个月后,出现与ARN综合征相符的单侧角膜炎、坏死性视网膜炎、视网膜血管炎、玻璃体炎和虹膜炎。对与眼内病变同时出现的角膜上皮溃疡以及房水(通过前房穿刺获取)进行印片细胞学检查。
印片细胞学检查发现与抗1型单纯疱疹病毒(HSV-1)抗体反应的细胞,并且在房水中检测到与HSV-1 DNA序列相对应的DNA片段。
该病例表明,ARN综合征在极少数情况下可能与HSV-1继发的疱疹性角膜炎相关。