帯状ヘルペス角膜炎の臨床像について

Clinical features of herpes zoster keratitis

　眼部帯状ヘルペス患者117例について，角膜炎の臨床像を検討した。角膜炎は上皮性角膜炎と実質性角膜炎とに分類し，さらに実質性角膜炎を4型に分類した。全経過中，65例（55.6％）に角膜炎を認め，上皮性角膜炎は40例（34.2％），実質性角膜炎は50例（42.7％）であった。実質性角膜炎のうち，上皮下浸潤が42例と最も多く，びまん性実質性角膜炎，円板状角膜炎，限局性実質性角膜炎はそれぞれ7例，6例，8例であった。上皮性角膜炎とびまん性実質性角膜炎は発病初期にのみみられたが，他の実質性角膜炎は経過を経て出現することが多かった。再燃は14例（12％）にみられ，中では上皮下浸潤が多かった。

We evaluated the corneal complications in 117 patients with herpes zoster ophthalmicus. The keratitis was classified into epithelial and stromal keratitis. The stromal keratitis was further subdivided into four types. During the course of observation, keratitis became manifest in 65 cases, 55.6%. Epithelial keratitis was present in 40 cases, 34.2%, and stromal keratitis in 50 cases, 42.7%. Among the four types of stromal keratitis, subepithelial infiltrates were present in 42 cases, diffuse stromal keratitis in 7, disciform keratitis in 6 and localized stromal keratitis in 8. Epithelial and diffuse stromal keratitis appeared only during the early stage of herpes zoster ophthalmicus, while other types of keratitis developed usually during the later course of the disease. There were 14 cases of recurrence, 12%. Subepithelial infiltrates were the most common manifestation of recurrence.