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要約 目的:角膜内皮炎の治療中に樹枝状角膜炎が生じた4症例の報告。症例と経過:4症例はすべて男性で,年齢は63~72歳(平均67歳)であった。いずれも片眼発症で,角膜内皮炎と診断された。3例ではステロイド点眼の開始から10日ないし2週間後,1例では8か月後に樹枝状角膜炎が発症した。3例では涙液からHSV-1,1例ではVZV-DNAが検出され,1例では前房水のHSV-1-DNAが陽性であった。全例でアシクロビルの眼軟膏または内服の追加で治癒した。結論:角膜内皮炎が疑われる症例では,ステロイド点眼に加えて抗ヘルペス薬を併用することが望ましい。
Abstract. Purpose:To report four cases who developed dendritic keratitis during treatment with corticosteroid for corneal endotheliitis. Cases and Findings:All the 4 cases were males aged from 63 to 72 years, average 67 years. All were unilaterally affected and were diagnosed with corneal endotheliitis. Dendritic keratitis in 3 cases developed 10 to 14 days after start of treatment with topical corticosteroid. It developed 8 months later in one case. Three cases showed HSV-1 in the tear fluid. One case showed VZV-DNA. HSV-1-DNA was positive in the aqueous in one case. Additional systemic or topical treatment with acyclovir resulted in cure in all the cases. Conclusion:Topical treatment with corticosteroid and antiherpetic agent is indicated for suspected corneal endotheliitis.
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