Wilhelmus K R, Dawson C R, Barron B A, Bacchetti P, Gee L, Jones D B, Kaufman H E, Sugar J, Hyndiuk R A, Laibson P R, Stulting R D, Asbell P A
Francis I Proctor Foundation, University of California San Francisco 94143-1412, USA.
Br J Ophthalmol. 1996 Nov;80(11):969-72. doi: 10.1136/bjo.80.11.969.
Possible risk factors were evaluated for herpes simplex virus (HSV) epithelial keratitis in patients with stromal keratouveitis.
The study population included 260 patients who had active stromal keratitis and/or iridocyclitis without epithelial disease and who were enrolled in one of three clinical trials of the Herpetic Eye Disease Study. Study treatment involved a 10 week course of topical placebo, topical prednisolone phosphate, or topical prednisolone phosphate with oral acyclovir. All groups received topical trifluridine four times daily for 3 weeks then twice daily for another 7 weeks. Patients were examined for HSV epithelial keratitis for 16 weeks.
Dendritic or geographic epithelial keratitis occurred in 12 (4.6%) study patients. Adverse effects attributable to trifluridine prophylaxis were acute allergic blepharoconjunctivitis in 10 (3.8%) study patients and corneal epithelial erosions in 11 (4.2%) study patients. No significant difference in the occurrence of HSV epithelial keratitis was found among the study treatment groups: one (2.0%) of 49 topical placebo treated patients, nine (6.5%) of 138 patients treated with topical corticosteroids without acyclovir, and two (2.7%) of 73 patients treated with topical corticosteroids and oral acyclovir. Univariate exponential models suggested that patients with a history of previous HSV epithelial keratitis and non-white patients were more likely to develop HSV epithelial keratitis during treatment of stromal keratouveitis.
Individuals with prior HSV epithelial keratitis and certain ethnic groups may have a higher rate of recurrent epithelial keratitis during the acute treatment of HSV stromal keratouveitis.
评估基质性角膜葡萄膜炎患者发生单纯疱疹病毒（HSV）上皮性角膜炎的可能危险因素。
研究人群包括260例患有活动性基质性角膜炎和/或虹膜睫状体炎但无上皮病变的患者，这些患者参与了疱疹性眼病研究的三项临床试验之一。研究治疗包括为期10周的局部用安慰剂、局部用磷酸泼尼松龙或局部用磷酸泼尼松龙联合口服阿昔洛韦。所有组均每日4次局部应用三氟胸腺嘧啶核苷，持续3周，然后每日2次，持续7周。对患者进行16周的HSV上皮性角膜炎检查。
12例（4.6%）研究患者发生了树枝状或地图状上皮性角膜炎。三氟胸腺嘧啶核苷预防导致的不良反应包括10例（3.8%）研究患者发生急性过敏性睑结膜炎和11例（4.2%）研究患者发生角膜上皮糜烂。在研究治疗组中，HSV上皮性角膜炎的发生率无显著差异：49例局部用安慰剂治疗的患者中有1例（2.0%），138例未用阿昔洛韦的局部用皮质类固醇治疗的患者中有9例（6.5%），73例局部用皮质类固醇和口服阿昔洛韦治疗的患者中有2例（2.7%）。单变量指数模型表明，既往有HSV上皮性角膜炎病史的患者和非白人患者在基质性角膜葡萄膜炎治疗期间更易发生HSV上皮性角膜炎。
既往有HSV上皮性角膜炎的个体和某些种族在HSV基质性角膜葡萄膜炎急性治疗期间复发性上皮性角膜炎的发生率可能更高。
