Discuss on the diagnosis and treatment of viral cornea endotheliitis / 眼科

ABSTRACT

Viral cornea endotheliitis is not uncommon,but misdiagnosis and missed diagnosis are often seen in clinic,and leading to serious results due to lack of knowledge.Cornea endotheliitis is mainly caused by simplex virus(HSV) or varicella zoster virus(VZV) infection.It can be classified clinically into three formslinear,disciform,and diffuse.The main manifestation is corneal edema associated with mutton-fat keratic precipitates.When an elevated IOP is accompanied as a result of combined trabecular meshwork inflammation,corneal endotheliitis can be misdiagnosed of glaucomatocyclitis.The two key points of treatment are anti-virus and antiinflammation.It is important to apply antiviral agents and cortical steroids appropriately.The administration route can be systematic and local.For most patients,local medication is the main route,but for those with recurrent lesion and severe inflammation,systemic application should be considered.The concentration and frequency of cortical steroids should be decided based on patient's condition individually.However,the principle is to apply cortical steroids of high bioavailability based on sufficient antiviral agent systematically and locally.It is very important to control inflammation rapidly,taper steroids gradually,and cease them slowly.