J Korean Ophthalmol Soc > Volume 58(5); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(5):516-522.
DOI: https://doi.org/10.3341/jkos.2017.58.5.516    Published online May 15, 2017.
Analysis of Clinical Manifestations and Prognostic Factors in Herpetic Endotheliitis.
Hyeon Jeong Yoon, Yong Sok Ji, Kyung Chul Yoon
Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea. kcyoon@jnu.ac.kr
헤르페스각막내피염의 임상양상 및 예후인자 분석
윤현정⋅지영석⋅윤경철
전남대학 의과대학 안과학교실
Correspondence:  Kyung-Chul Yoon, MD, PhD
Email: kcyoon@jnu.ac.kr
Received: 9 February 2017   • Revised: 14 March 2017   • Accepted: 25 April 2017
Abstract
PURPOSE
We aimed to analyze the clinical features of herpetic endotheliitis and to investigate the risk factors for recurrence of herpetic endotheliitis and corneal decompensation. METHODS: The medical records of 58 patients (58 eyes) who were diagnosed with herpetic endotheliitis were retrospectively reviewed. Patients with a follow-up period of less than 6 months and a previous history of ocular inflammation were excluded from this study. We recorded visual acuity, intraocular pressure, central corneal thickness, and endothelial cell density on both initial and final visit, and recorded clinical findings of the anterior and posterior segments of the eye only on initial visit. Factors affecting the recurrence of herpetic endotheliitis and corneal decompensation were also analyzed. RESULTS: Among the 58 patients, 45 patients had disciform type endotheliitis, 11 patients had diffuse type, and 2 patients had linear type. There were no significant differences between final clinical manifestations according to subtype. 14 patients exhibited recurrence of herpetic endotheliitis. High intraocular pressure and high-grade anterior chamber cells were associated with the recurrence of herpetic endotheliitis. On multivariate analysis, the only risk factor for the recurrence of herpetic endotheliitis was high intraocular pressure. We found that 8 patients exhibited corneal decompensation, and high intraocular pressure, high anterior chamber cell grade, and a history of cataract surgery were associated with corneal decompensation. On multivariate analysis, the risk factors for corneal decompensation were high anterior chamber cell grade and cataract surgery history. CONCLUSIONS: For herpetic endotheliitis, the subtype did not affect the final records of clinical manifestation, and the only risk factor for the recurrence of herpetic endotheliitis was high intraocular pressure. Additionally, the risk factors of corneal decompensation were found to be high-grade anterior chamber cells and a history of cataract surgery. Initial examinations of clinical manifestation are important for the successful treatment of herpetic endotheliitis.
Key Words: Disciform keratitis;Herpetic endotheliitis


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