1/19. Progressive outer retinal necrosis and acute retinal necrosis in fellow eyes of a patient with acquired immunodeficiency syndrome.PURPOSE: To describe an unusual concurrence of acute retinal necrosis and progressive outer retinal necrosis in fellow eyes of a patient with acquired immunodeficiency syndrome (AIDS). methods: Interventional case report. In a 37-year-old man with AIDS and herpes zoster keratitis in the right eye, progressive outer retinal necrosis developed in the right eye and acute retinal necrosis developed in the left eye. RESULTS: Disparate presentations of retinitis persisted in each eye, and retinal detachment and vision loss ensued in both eyes despite antiviral therapy. CONCLUSION: Distinct features of acute retinal necrosis and progressive outer retinal necrosis do not necessarily reflect systemic factors, and they may be variant manifestations of the same underlying infection.- - - - - - - - - - ranking = 1keywords = keratitis (Clic here for more details about this article) |
2/19. herpes zoster ophthalmicus and the superior orbital fissure syndrome.herpes zoster ophthalmicus (HZO) is not an uncommon condition in the elderly and the immunocompromised. The common ocular manifestations include blepharoconjunctivitis, keratitis and uveitis. Dramatic presentations like orbital apex syndrome and superior orbital fissure syndromes occur rarely in patients with herpes zoster meningo-encephalitis.We report a patient with herpes zoster meningo-encephalitis and the superior orbital fissure syndrome (SOFS).- - - - - - - - - - ranking = 1keywords = keratitis (Clic here for more details about this article) |
3/19. Corneal epithelial keratitis in herpes zoster ophthalmicus: "delayed" and "sine herpete". A non-contact photomicrographic in vivo study in the human cornea.PURPOSE: To investigate the origin of corneal epithelial keratitis occurring without accompanying herpes zoster ophthalmicus (HZO) cutaneous rash. methods: Corneal epithelial lesions in seven patients (four with a history of classical HZO with cutaneous rash, one of herpes zoster oticus, and two with no history of herpes zoster, were examined with the slit lamp and photographed by non-contact in vivo photomicrography. The findings were compared with lesions in classical acute HZO. polymerase chain reaction (PCR) was done in three patients. RESULTS: Slit lamp appearance, morphology at higher magnification, and kinetics of the lesions were indistinguishable from classical acute HZO. PCR was positive for varicella-zoster virus dna in all three samples. CONCLUSIONS: The findings strongly suggest that HZO typical corneal epithelial lesions occurring in the absence of cutaneous rash are in fact recurrent episodes of virus shedding.- - - - - - - - - - ranking = 5keywords = keratitis (Clic here for more details about this article) |
4/19. Herpes zoster virus sclerokeratitis and anterior uveitis in a child following varicella vaccination.PURPOSE: To report a case of herpes zoster virus sclerokeratitis with anterior uveitis following vaccination with live attenuated varicella vaccine (Oka strain). DESIGN: Case report. methods: The case records of the patient were reviewed retrospectively. Pertinent literature citations were identified using medline. RESULTS: A 9-year-old boy presented with herpes zoster ophthalmicus 3 years following vaccination with live attenuated varicella vaccine (Oka strain). Examination of the affected eye revealed a moderate follicular response on the palpebral conjunctiva, decreased corneal sensation, mildly elevated intraocular pressure, diffuse anterior scleritis with marginal keratitis, and a moderately severe anterior uveitis. Amplified dna from fluid taken from the base of a cutaneous vesicle produced wild-type varicella zoster virus (VZV) dna, not Oka strain. CONCLUSIONS: Herpes zoster virus infection needs to be considered in all patients who present with scleritis, keratitis, or anterior uveitis, regardless of their varicella vaccination status.- - - - - - - - - - ranking = 7keywords = keratitis (Clic here for more details about this article) |
5/19. Corneal surface changes in Thygeson's superficial punctate keratitis: a clinical and non-contact photomicrographic in vivo study in the human cornea.PURPOSE: To elucidate mechanisms behind the morphology of Thygeson's superficial punctate keratitis (TSPK). methods: Sixteen patients were examined with the slit lamp and photographed by non-contact photomicrography. The results were compared with morphology of epithelial keratitis in herpes simplex type 1 (HSV1), varicella zoster (VZV), and adenovirus type 8 (Ad8) infections, all previously studied by the same method, and with published histologic findings in TSPK. RESULTS: In the photographs, the corneal epithelium showed various numbers of abnormal subsurface cells measuring about 10-15 microm in diameter, present individually, in small groups, or aggregated in larger lesions (coarse lesions with the slit lamp). The surface epithelium was well preserved, except in larger lesions, which showed surface debris. The morphology was unlike HSV1 and VZV epithelial keratitis, but strongly resembled epithelial changes occurring in Ad8 infections on day 5, and later, after the onset of symptoms. CONCLUSIONS: TSPK shows a more widespread epithelial involvement than suspected with the slit lamp. Its morphology seems to reflect an action of a noxious agent targeted at the deeper epithelial layers, with the appearance of abnormal cells as a result. These might represent invading inflammatory cells, damaged intraepithelial ones, or both. The coarse lesions visualize areas of major involvement showing discernible signs of cell destruction. The similarity to Ad8 keratitis suggests that the source of the noxious agent might be located outside the cornea. The morphology, in conjunction with clinical features, is compatible with an immunologically mediated injury. The etiology remains unknown.- - - - - - - - - - ranking = 8keywords = keratitis (Clic here for more details about this article) |
6/19. Chronic recurrent varicella-zoster virus keratitis confirmed by polymerase chain reaction testing.PURPOSE: To report a case of chronic recurrent varicella virus epithelial keratitis in a child. DESIGN: Case report. methods: Clinical examination and polymerase chain reaction analysis of corneal epithelium. RESULTS: A 10-year-old healthy child developed chronic recurrent varicella virus keratitis with pseudodendrites after recovering from systemic varicella. Analysis of the debrided pseudodendrites was repeatedly positive for VZV dna and negative for HSV dna. Treatment with oral acyclovir and topical corticosteroid drops was effective in eliminating the pseudodendrites; however, recurrences occurred once the medications were discontinued. CONCLUSIONS: Varicella virus epithelial keratitis in children can be a recurrent chronic condition requiring prolonged treatment.- - - - - - - - - - ranking = 7keywords = keratitis (Clic here for more details about this article) |
7/19. A case of complete ophthalmoplegia in herpes zoster ophthalmicus.PURPOSE: To report a case with complete ophthalmoplegia after herpes zoster ophthalmicus. methods: A 70-year-old male patient visited a clinic because of vesicular eruptions over the left side of his face with severe pain. Drooping and severe swelling of the left eyelid were present, along with keratitis and uveitis. While the lid swelling and uveitis were improving, external ophthalmoplegia and exophthalmos were discovered. Intramuscular injections of dexamethasone 5 mg were given for 10 days, followed by oral administration of prednisolone at a dosage of 15 mg for two weeks and 10 mg for two weeks. RESULTS: The patient was fully recovered from the complete ophthalmoplegia and exophthalmos six months after the onset of the cutaneous lesion. CONCLUSIONS: Complete ophthalmoplegia is a rare ophthalmic complication of herpes zoster infection. Therefore, an evaluation of extraocular muscle and lid function should be performed during the examination of herpes zoster patients in order to screen for ophthalmoplegia.- - - - - - - - - - ranking = 1keywords = keratitis (Clic here for more details about this article) |
8/19. Clinical profile of herpes zoster ophthalmicus.herpes zoster ophthalmicus was seen in 22 cases out of 195 cases of herpes zoster (11.3% incidence). It was affecting mainly adults (90.9%). Oedema over the lids (81.8%) was invariably present and lead to ptosis. Mucopurulent conjunctivitis, predominantly mucoid (72.7%) was the commonest manifestation associated with vesicles over the lid margins. Sectorial (22.7%) and diffuse (9.1%) episcleritis appeared in later part of first week, while nodular episcleritis was observed in one case only on 12th day of the disease. Nummular keratitis was seen in 31.8% of cases between 8-10 days. iritis and iridocyclitis was seen in 45.4% of cases out of which 36.3% had secondary ocular hypertension (glaucoma). Neuroparalytic keratitis and internal ophthalmoplegia were detected in one patient each. Postherpetic neuralgia occurred in 22.7% of cases and was uncommon in younger age group (below 40 years, 4.5%). carbamazepine was effective in relieving the herpetic pain.- - - - - - - - - - ranking = 2keywords = keratitis (Clic here for more details about this article) |
9/19. herpes zoster ophthalmicus and iris cysts.herpes zoster ophthalmicus has been associated with numerous complications such as neuropathy, keratitis, anterior uveitis, and neuralgia. To my knowledge, there have been no reports of secondary iris cyst formation. I hereby report the case of a patient who developed an iris cyst during a herpes zoster ophthalmicus infection.- - - - - - - - - - ranking = 1keywords = keratitis (Clic here for more details about this article) |
10/19. Sectorial corneal infiltrates and pannus in herpes zoster ophthalmicus.We report four patients with herpes zoster ophthalmicus who developed a dense pannus limited to a sector of the superior cornea that advanced to the central region of the cornea. The pannus appeared to develop in response to peripheral infiltrates in a subepithelial or anterior stromal location and not in association with disciform corneal edema, interstitial keratitis, or scleritis. The corneal pannus developed insidiously as a late complication without associated ulceration and with little or no anterior uveitis or conjunctival reaction. Additionally, all four patients developed anterior and mid-stromal infiltrates in a punctate or incomplete ring configuration at the leading border of the pannus that threatened the visual axis. In the three patients that were treated with topical corticosteroids, the infiltrates resolved with preservation of visual acuity. The other patient developed central scarring with a permanent reduction in vision. patients with infiltrates and pannus in a sector of the cornea should be followed carefully and treated with topical corticosteroids when infiltrates appear to prevent progression to the central cornea.- - - - - - - - - - ranking = 1keywords = keratitis (Clic here for more details about this article) |
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