水痘-带状疱疹病毒性角膜葡萄膜炎继发青光眼1例报告及文献复习  

Secondary glaucoma caused by varicella-zoster virus keratouveitis:A case report and literature review

作　　者：袁福杰 裴颖[1] 王英[1] YUAN Fujie;PEI Ying;WANG Ying(Department of Ophthalmology,Second Hospital,Jilin University,Changchun 130022,China)

机构地区：[1]吉林大学第二医院眼科,吉林长春130022

出　　处：《吉林大学学报（医学版）》2022年第1期211-215,共5页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅科技发展计划项目(20190201051JC)。

摘　　要：目的:分析水痘-带状疱疹病毒(VZV)性角膜葡萄膜炎继发青光眼患者的临床表现,探讨其治疗方案。方法:收集1例VZV性角膜葡萄膜炎继发性青光眼患者的临床资料,并结合相关文献,分析患者的临床表现、诊断及治疗方案。结果:患者,女性,55岁,因左眼视力下降40余天入院。查体,左眼结膜充血,角膜弥漫性水肿,可见大量色素角膜后沉着物(KP),房水混浊、闪辉,虹膜脱色素,部分虹膜后粘连,眼底视不清;房角镜检查见房角大量色素沉积,房水病毒抗原检测显示VZV呈强阳性,确诊为VZV性角膜葡萄膜炎继发青光眼,给予局部联合全身抗炎、抗病毒和降眼压药物治疗,眼压下降不明显,行前房冲洗术后患者眼压下降,病情好转出院。结论:房水病毒抗原检测是诊断VZV性角膜葡萄膜炎的有效方法,对于房角大量色素沉积的VZV性角膜葡萄膜炎继发青光眼患者,前房冲洗是一种有效的治疗手段。Objective:To analyze the clinical manifestations of secondary glaucoma caused by varicella-zoster virus(VZV)keratouveitis,and to explore its treatment plan.Methods:The clinical information of a patient with secondary glaucoma caused by VZV keratouveitis was collected,and the relevant literatures were reviewed.The clinical symptoms,diagnosis,and treatment of secondary glaucoma caused by VZV keratouveitis were analyzed.Results:The female patient aged 55 years old was admitted to hospital because of“visual acuity of the left eye decreased for more than 40 d”.Physical examination showed conjunctival congestion in the left eye,diffuse corneal edema,endothelial pigment keratic precipitates(KP),aqueous humor turbidity and glow,iris depigmentation,part of iris posterior synechia,and fundus blurred.The gonioscope results showed a large amount of pigmentation in the chamber angle,and aqueous humor virus detection showed that VZV was strongly positive,which was diagnosed as secondary glaucoma caused by VZV keratouveitis.The patient was locally treated with systemic anti-inflammatory,antiviral and intraocular pressure-lowering drugs,and the intraocular pressure was decreased insignificantly.After anterior chamber irrigation,the intraocular pressure was decreased,and the condition was improved and the patient was discharged from the hospital.Conclusion:Aqueous virus testing is an effective method for diagnosing VZV keratouveitis,anterior chamber washout is a successful treatment for glaucoma caused by VZV keratouveitis with a lot of pigmentation in the corners.

关 键 词：水痘-带状疱疹病毒 角膜炎 葡萄膜炎 继发性青光眼 前房冲洗术 

分 类 号：R772.21[医药卫生—眼科] R773.9[医药卫生—临床医学]