Clinical Analysis of Herpetic Keratitis in Korea. |
Joon Seo Hwang, Won Ryang Wee, Jin Hak Lee, Mee Kum Kim |
1Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. kmk9@snu.ac.kr 2Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea. 3Department of Ophthalmology, Seoul National University Bundang Hospital, Gyeonggi, Korea. |
한국인 단순포진각막염 환자의 임상 분석 |
황준서1,2,위원량1,2,이진학1,3,김미금1,2 |
Department of Ophthalmology, Seoul National University College of Medicine1, Seoul, Korea Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute2, Seoul, Korea Department of Ophthalmology, Seoul National University Bundang Hospital3, Gyeonggi, Korea |
Correspondence:
Mee Kum Kim, M.D. |
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Abstract |
PURPOSE To investigate the clinical characteristics of herpetic keratitis in Korea. METHODS: A retrospective analysis was performed on 90 eyes of 84 patients who were clinically diagnosed with herpetic keratitis and were followed for at least 4 months or more. Information on prior herpetic keratitis, type of keratitis, time to remission, recurrence rate, administration of oral acyclovir, final visual acuity was reviewed. Remission time and recurrence rate were compared according to types of herpetic keratitis and the application of oral acyclovir in epithelial, stromal or endothelial keratitis; and the relation of history of previous herpetic keratitis, recurrence and final vision, was analyzed. RESULTS: Sex ratio (M:F) was 1.31 and the mean age was 54.6 years. Of 90 eyes, the proportion of infectious epithelial keratitis, stromal keratitis, endothelitis and neurotrophic ulcer was 51.1, 17.8, 25.6 and 5.6%, respectively. The mean remission time was 1.92+/-1.01, 4.13+/-5.05, 5.52+/-5.08, 4.00+/-1.00, respectively (p=0.001, one-way Anova). Recurrence occurred in 21 (42.9%) eyes of 49, which were followed up for more than 12 months, in a year after the previous attack. The rates of recurrence of infectious epithelial keratitis, stromal keratitis and endothelitis were 25.0%, 63.6% and 53.8%, respectively. Oral acyclovir neither shortens the remission nor prevents the recurrence. The percentage of final vision over 20/40 in infectious epithelial keratitis, stromal keratitis and endothelitis was 81.1, 57.1 and 60.0%, respectively. The final vision was worse in the group with a history of herpetic keratitis. CONCLUSIONS: Stromal keratitis and endothelitis showed a higher recurrence rate and longer remission time than infectious epithelial keratitis. Because recurrent and severe keratitis may result in corneal opacity and vision loss, aggressive and proper treatment is needed. However, these cases are often resistant to therapy. |
Key Words:
Herpes simplex keratitis;Oral acyclovir;Recurrence;Visual loss;Stromal keratitis |
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