Martínez M J, Vogel M, Stoppel J, Charlin R, Squella O, Srur M, Traipe L, Verdaguer J, Suárez M
Departamento de Microbiología, Facultad de Medicina, Universidad de Chile.
Rev Med Chil. 1997 Jun;125(6):659-64.
Herpetic keratitis is the main infectious cause of corneal opacity. The existence of effective antiviral agents underscores the need of an early diagnosis.
To correlate clinical features of herpetic keratitis with virological studies.
Forty one patients with a clinical diagnosis of herpetic keratitis were studied. Viral isolation, polymerase chain reaction (PCR) and typification were done in a sample taken by swabbing the ocular lesion.
Twenty six patients (31% female) had epithelial keratitis, that was mild or moderate in 88% of cases and acute in 77% of them. In 20 patients (77%), viral isolation and PCR were positive (HSV-2 in one case). Fifteen patients (67% female) had stromal keratitis, 93% of cases were moderate or severe and 53% were acute. Viral isolation was negative in all cases and in 20% PCR was positive.
Viral isolation and PCR were equally sensitive in epithelial keratitis, but in stromal keratitis only PCR could detect the virus. Moderate acute dendrite was the predominant clinical manifestation. The higher proportion of women with stromal keratitis supports its possibly autoimmune etiology. HSV-2 is seldomly isolated and possibly associated to vertical transmission.
疱疹性角膜炎是角膜混浊的主要感染原因。有效抗病毒药物的存在凸显了早期诊断的必要性。
将疱疹性角膜炎的临床特征与病毒学研究相关联。
对41例临床诊断为疱疹性角膜炎的患者进行研究。通过擦拭眼部病变采集样本进行病毒分离、聚合酶链反应（PCR）及分型。
26例患者（女性占31%）患有上皮性角膜炎，其中88%为轻度或中度，77%为急性。20例患者（77%）病毒分离及PCR呈阳性（1例为HSV - 2）。15例患者（女性占67%）患有基质性角膜炎，93%为中度或重度，53%为急性。所有病例病毒分离均为阴性，20%的病例PCR呈阳性。
病毒分离和PCR在上皮性角膜炎中敏感性相同，但在基质性角膜炎中只有PCR能检测到病毒。中度急性树枝状角膜炎是主要临床表现。基质性角膜炎女性比例较高支持其可能的自身免疫病因。HSV - 2很少分离到，可能与垂直传播有关。
