結膜ヘルペスと考えられる7例

Seven cases of herpetic geographic ulceration of conjunctiva

　過去3年間に，阪大眼科で単純ヘルペスウイルスⅠ型（HSV−1）が原因となって結膜に地図状潰瘍を呈したと考えられる結膜ヘルペス7例について検討した．

　7例中5例（71％）（うち4例は，ステロイド局所投与中）は実質型角膜ヘルペス治療中および経過観察中に，残り2例（29％）は上皮型角膜ヘルペス治療中および角膜移植術後の経過観察中に結膜ヘルペスが発症した．1例にHSV−1を同定した．ゾビラツクス眼軟膏^® （ACV-V）の投与中であったのは4例（57％）で，そのうち3例は点入回数を増やすことで治癒した．残り3例（43％）はACV-Vまたは，IDUの頻回点眼で治癒した．

We observed 7 cases who manifested geographic ulcerations in the bulbar conjunctiva due, to herpes simplex type 1 (HSV-1). The conjunctival ulcera-tions developed during treatment of herpetic epith-elial keratitis in 1 eye, during the follow-up of keratoplasty in 1 eye, and during or after treatment of herpetic stromal keratitis in 5 eyes, of which topical steroid was currently in use in 4 eyes. HSV-1 was isolated from the conjunctival lesion in 1 case.

The therapy was changed immediately when we recognized the conjunctival ulcerations. We added or increased the frequency of topical antiviral agents. The conjunctival ulcerations healed within one week in all the cases. We believe it is necessary to examine not only the cornea but also conjunctiva for the patients with herpetic stromal keratitis.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(8) : 1025-1027, 1987