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@#The virus-related corneal endotheliitis has diverse inducement, complex etiology, unclear pathogenesis, diverse clinical manifestations. There is no unified classification at present. Auxiliary diagnosis technology is improving constantly, loop-mediated isothermal amplification and all kinds of PCR have a certain auxiliary role in the diagnosis of this disease. But the diagnosis also mainly relys on history and clinical manifestation in clinic. Anti-viral drug and glucocorticoid are the main treatment. Virus-related corneal endotheliitis has high recurrence rate, so there is an urgent need to research new drugs and new treatment. Experiment researches of genetic engineering drugs, such as vaccines, unwinding-primers enzyme inhibitors, and chemokine receptors, bring hope to the treatment of virus-related corneal endotheliitis. The purpose of this article is to review the related research of virus-related corneal endotheliitis.
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·AIM: To observe the clinical effect and the changes of corneal endothelial morphology of glucocorticoid combined with antiviral therapy for viral corneal endotheliitis and evaluate the safety of this treatment. ·METHODS: The clinical data like predisposing factors, history and clinical manifestation were retrospectively analyzed, the 48 patients (48 eyes) with viral corneal dermatitis from January 2014 to December 2015 in Xi'an No.4 Hospital were included. A comparative study was conducted between affected eyes and healthy eyes. The cure rate, recurrence rate and corneal endothelial morphological changes of patients treated with combined treatment of glucocorticoid and antiviral drugs after 3mo were compared and analyzed statistically. · RESULTS: Corneal endotheliitis patients had many predisposing factors and symptoms like red eye, eye pain, photophobia, tears and decreased visual acuity, blurred vision and others, clinical manifestations include decreased visual acuity,conjunctival congestion or mixed ciliary congestion, corneal edema, corneal epithelium might have small blisters, Descemet membrane folds, gray white or white like KP, intraocular pressure increased, posterior synechia, cases of several recurrent had corneal bullous occurred. After 1mo of treatment,the effective rate was 100%,the cure rate was 88%,and there was no recurrence; after 2mo of treatment the effective rate and the cure rate was 100%, a total of 1 cases (2%) recurrence;treatment for 3mo, a total of 2 cases (4%) recurrence. After 3mo of treatment cell count (t=2.952, P=0.004) and corneal thickness by OCT (t=2.584, P=0.011) of the treatment group were lower than those of the control group, the difference was statistically significant; cell pleomorphic mutation rate (45. 85% ± 6.29%) of the treatment group was higher than that of the control group (40. 62% ± 5. 16%), the difference was statistically significant (t=4.458, P<0.001). The visual acuity of treatment group was poorer before treatment than that of the control group, the difference was statistically significant (Z = - 5. 766, P < 0. 001); after treatment, the visual acuity increased to 0. 20 (0. 10-0.40),there were significant differences before and after the treatment (Z=-6.089,P<0.001). ·CONCLUSION: The clinical manifestations and etiology of viral corneal endotheliitis is complex. Application of antiviral drugs and glucocorticoid treatment, can obtain good effect, but after the treatment, corneal thickness and corneal endothelial cell count decreased, higher requirements for the safety of the treatment is needed.
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· AIM: To analyze the pathogeny of corneal endotheliitis and to investigate the causes of its misdiagnosis and the key to treatment.endotheliitis presented with predisposing factors, clinical manifestations and treatment were analyzed retrospectively.junctiviis, and the other 7 were misdiagnosed as acute close-angle glaucoma, glaucomatocyclitic crisis, inflammatory reaction after cataract extracapsular extraction and IOL implantation, disciform stromal keratitis and iridocyclitis, respectively. All the 7 cases were cured through treatment, and recurrence appeared in 1 case.unclear yet. Properly grasping its features and key points for differential diagnosis and seriously and detailed examining patients will benefit to timely diagnosis. After clinical treatment, maintaining treatment for more than 4wk will lower the recurrence of corneal endotheliitis.
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It is not uncommon for corneal endotheliitis in clinic.Misdiagnosis of the disease was often happened because of the insufficient knowledge on it and lacking of specific examine methods.It is the most important method for avoiding misdiagnosis of corneal endotheliitis to recognize its clinic features and detailed inquiring case history.