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inflammation of the cornea and conjunctiva

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/01/25 04:08:00」(JST)

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Herpetic keratoconjunctivitis is a form of keratitis and conjunctivitis associated with herpes simplex virus.^[1]^:370

It begins with infection of epithelial cells on the surface of the eye and retrograde infection of nerves serving the cornea.^[2] Primary infection typically presents as swelling of the conjunctiva and eyelids (blepharoconjunctivitis), accompanied by small white itchy lesions on the surface of the cornea. The effect of the lesions varies, from minor damage to the epithelium (superficial punctate keratitis), to formation of dendritic ulcers.^[3] Infection is unilateral, affecting one eye at a time. Additional symptoms include dull pain deep inside the eye, mild to acute dryness, and sinusitis. Most primary infections resolve spontaneously in a few weeks. Healing can be aided by the use of oral and topical antivirals.

Subsequent recurrences may be more severe, with infected epithelial cells showing larger dendritic ulceration, and lesions forming white plaques.^[3] The epithelial layer is sloughed off as the dendritic ulcer grows, and mild inflammation (iritis) may occur in the underlying stroma of iris. Sensation loss occurs in lesional areas, producing generalised corneal anaesthesia with repeated recurrences.^[3] Recurrence can be accompanied by chronic dry eye, low grade intermittent conjunctivitis, or chronic unexplained sinusitis. Following persistent infection the concentration of viral DNA reaches a critical limit. Antibody responses against the viral antigen expression in the stroma can trigger a massive autoimmune response in the eye. The response may result in the destruction of the corneal stroma,^[3] resulting in loss of vision due to opacification of the cornea. This is known as immune-mediated stromal keratitis.

References

^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
^ Carr DJ, Härle P, Gebhardt BM (2001). "The immune response to ocular herpes simplex virus type 1 infection". Exp. Biol. Med. (Maywood) 226 (5): 353–66. PMID 11393165.
^ ^a ^b ^c ^d Suresh PS, Tullo AB (1999). "Herpes simplex keratitis". Indian J Ophthalmol 47 (3): 155–65. PMID 10858770.

UpToDate Contents

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1. 単純ヘルペスウイルス1型感染の臨床症状および診断 clinical manifestations and diagnosis of herpes simplex virus type 1 infection
2. アトピー性角結膜炎 atopic keratoconjunctivitis
3. 結膜炎 conjunctivitis
4. 春季カタル vernal keratoconjunctivitis
5. シェーグレン症候群による全身および腺外症状の治療 treatment of systemic and extraglandular manifestations of sjogrens syndrome

English Journal

[Cyclosporine eye drops: A 4-year retrospective study (2009-2013)].

Kauss Hornecker M1, Charles Weber S2, Brandely Piat ML1, Darrodes M1, Jomaa K1, Chast F1.
Journal français d'ophtalmologie.J Fr Ophtalmol.2015 Oct;38(8):700-8. doi: 10.1016/j.jfo.2015.02.008. Epub 2015 Sep 11.
INTRODUCTION: The University Hospitals Paris Centre Pharmacy compounds three concentrations of cyclosporine eye drops: 20mg/mL (=2%); 5mg/mL (=0.5%) and 0.5mg/mL (=0.05%). Cyclosporine A 2% drops were developed in 1995 to prevent the rejection of high-risk cornea transplants after failure of topical
PMID 26371985

[Bilateral vascularized disciform corneal scar of herpetic origin in a child].

Fiorentzis M1, Szentmáry N, Seitz B.
Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft.Ophthalmologe.2015 Feb;112(2):162-5. doi: 10.1007/s00347-014-3070-8.
BACKGROUND: Bilateral keratitis is rare and can have various causes. For a good outcome after treatment, the correct diagnosis is decisive.CASE REPORT: A 15-year-old boy presented to our clinic with recurrent keratoconjunctivitis and progressive loss of vision in both eyes since 6 years. The best co
PMID 25030897

Ranibizumab injection for corneal neovascularization refractory to bevacizumab treatment.

Ahn YJ1, Hwang HB1, Chung SK1.
Korean journal of ophthalmology : KJO.Korean J Ophthalmol.2014 Apr;28(2):177-80. doi: 10.3341/kjo.2014.28.2.177. Epub 2014 Mar 14.
Vascular endothelial growth factor inhibitor is an emerging therapeutic modality for various ocular diseases with neovascularization (NV). However, for corneal NV, controversy remains regarding whether bevacizumab or ranibizumab is superior. A 32-year-old female diagnosed with herpetic keratoconjunc
PMID 24688262

Japanese Journal

免疫抑制点眼薬使用中に発症した角膜ヘルペス

東京女子医科大学雑誌 82(E1), E244-E248, 2012-01-31
NAID 110008767985

ステロイド忌避傾向のアトピー性皮膚炎患者に生じた難治な角膜ヘルペスの1例

東京女子医科大学雑誌 82(E1), E194-E197, 2012-01-31
NAID 110008767974

慢性移植片対宿主病罹患児に対する歯科的管理

小児歯科学雑誌 40(3), 565-570, 2002-06-25
NAID 10012156367

「ヘルペス性角結膜炎」

Herpesviral ocular disease
Classification and external resources
ICD-10	B00.5
ICD-9	054.4
MeSH	D016849

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英: herpetic keratoconjunctivitis

[Andrews-1] James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.

[pmid11393165-2] Carr DJ, Härle P, Gebhardt BM (2001). "The immune response to ocular herpes simplex virus type 1 infection". Exp. Biol. Med. (Maywood) 226 (5): 353–66. PMID 11393165.

[pmid10858770-3] Suresh PS, Tullo AB (1999). "Herpes simplex keratitis". Indian J Ophthalmol 47 (3): 155–65. PMID 10858770.

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herpetic keratoconjunctivitis