几种特殊类型单疱病毒性角膜炎的诊疗__培训课件.pptVIP

perforation, infection necrosis, ulceration, thinning, perforation B. Immune stromal (interstitial) keratitis retained viral antigen within the stroma Stromal infiltration immune ring stromal neovascularization，sectoral stromal keratitis stromal keratitis stromal keratitis III. Endotheliitis stromal edema without stromal infiltrate keratic precipitates (KP), overlying stromal and epithelial edema, and iritis the presence of HSV I antigen in corneal endothelial cells three forms: disciform, diffuse, and linear A. Disciform endothelitis KP iritis edema from endothelial decompensation sensitive to topical corticosteroids ???? Herpes simplex disciform keratitis ???? B. Diffuse endotheliitis scattered KP over the entire cornea with overlying diffuse stromal edema iritis In severe cases, a dense, retrocorneal plaque of inflammatory cells accompanied by hypopyon may be seen ???? Diffuse endotheliitis ???? C. Linear endotheliitis line of KP KP can be sectoral or, in some cases, circumferential edema between the KP and the limbus KP located at the leading edge of the edema both corticosteroids and antiviral agents ???? Linear endotheliitis ???? Diagnosis thorough ophthalmic examination viral culture: slow Cytologic examination of specimens stained with Giemsa or Wright stains, Multinucleated giant cells, nonspecific, intranuclear inclusions Immunologic tests:The Herpchek, Virogen-latex agglutination, enzyme immunofiltration, and the 1-hour enzyme linked immunoassay can detect HSV antigen in cell culture and direct specimens within 5 hours electron microscopy DNA hybridization techniques Serum antibody titers: diagnosis of primary infection Treatment Debridement Drug therapy Surgical Control of trigger mechanisms of recurrent Debridement Dendritic keratitis Wound cotton-tipped applicator No topical iodine or ether Cycloplegic With antiviral Drug therapyAntiviral agents idoxuridine (IDU) vidarabine or Ara-A trifluridine (F3T) Cyclocytidine(CC)