Clinical effect and morphological analysis of combined therapy for viral corneal endothelial inflammation / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

·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.