The Clinical Observation Of 24 Cases Of Virus-related Corneal

Purpose:The purpose of this study is to explore the clinical features, suitable mode of therapy and potential pathogenic mechanism of virus-related corneal endotheliitis.Methods: We collected 24 cases of virus-related corneal endotheliitis treated in the first hospital affiliated to fujian medical university. The triggers, clinical manifestations, and recurrence were analysis retrospectively. The changes of symptoms before and after 3, 5, 7 days of treatment with systemic and topical antiviral medication combining with glucocorticoids were recorded and scored. We evaluated the scores for cure, effective. progress and invalid according to effective index,then calculated the invalid, efficient and cure rate. Visual acuity before and after treatment were observed.Results: There were a variety of triggers for virus-related corneal endotheliitis. The clinical manifestations were complex and varied, including different degrees of vision loss, conjunctival or ciliary hyperemia, corneal edema, corneal epithelial vesicles, Descemet’s membrane creases, gray or suet keratic precipitates(KPs), Tyndall(+),elevated intraocular pressure, posterior synechia of the iris, and big bubble of cornea occurred in recurrent cases. Visual acuity improved after comprehensive treatment(p < 0.001), the median vision was 0.135 on admission and reached to 0.5 when out of the hospital, and increased t0-11 lines with a median of 4 lines. Recurrence had significantly impaired visual acuity, between light feeling to 0.15, the improvement was not ideal. visual acuity of 5 cases who were disciform corneal endotheliitis improved to 1.0. Disciform corneal endotheliitis recovered faster than the other two forms. Symptoms could be improved 3 days after the medication generally, corneal edema faded after 7 days’ threatment.,but KPs still existed. 8(72.67%) in 11 cases who were Tyndall positive turned to negative 4 to 5 days after treatment. 1to2 weeks after treatment cornea restored transparent, Descemet’s membrane creases and KP significantly reduced or fade, and cornea nebula or macula left over in a small part of cases. Stromal keratitis could occur in recurrence,and cornealdamage was serious. The cure rate was 0.00%, 0.00%, 16.67%,efficient rate was 0.00%, 12.50%、87.50% and invalid rate was 66.67%、8.33%、0.00%, 3, 5, and 7 days after treatment respectively. 5 in 16 cases relapsed after the follow-up, 1 case relapsed within 2 years after stopping treatment, 4 within 1 year. Corneal endotheliitis could been misdiagnosed easyly, the misdiagnosis rate was high, up to 33.3%.Conclusion: Diagnosis of virus-related corneal endotheliitis at disease onset was complex, often confusing, and due to the varied clinical manifestations. Moreover, the causative factors were still unknown and lack of specific means of checking made it more difficult. Once diagnosed, if combination treatment with antiviral drugs and glucocorticoids are applied in time, it will achieve good effect. Making prompt diagnosis and promoting standardization offered a breakthrough against the historically poor visual outcomes associated with patients with virus-related corneal endotheliitis, then contributed to improve the cure rate Develop and promote the standard treatment of virus-related corneal endotheliitis has important significance to improve the cure rate, reduce the blindness rate.