典必殊联合阿昔洛韦治疗单疱病毒性角膜炎的疗效观察

目的:探讨典必殊滴眼液联合阿昔洛韦(无环鸟苷,ACV)滴眼液治疗单疱病毒性角膜炎(herpes simplex keratitis,HSK)的疗效。方法:将43例46眼HSK患者随机分两组,典必殊治疗组23例25眼,贝复舒对照组20例21眼,将其临床资料进行回顾性分析,观察临床治疗效果。结果:浅层型全部治愈,深层型典必殊治疗组有效率87.5%,贝复舒对照组有效率60.0%,治愈时间典必殊治疗组平均12d,贝复舒治疗组平均17d;复发率典必殊治疗组34.8%,贝复舒对照组55.0%。两组相比差异有统计学意义(P<0.05)。结论:典必殊联合阿昔洛韦治疗HSK,具有明显的协同作用,能提高治愈率,缩短病程,降低复发,尤其对深层型单疱病毒性角膜炎疗效显著。     

环孢霉素A滴眼液治疗单疱病毒性角膜基质炎疗效观察

目的:观察10g/L环孢霉素A滴眼液治疗单疱病毒性角膜基质炎临床疗效。方法:我院2011-01/2012-01治疗单疱病毒性角膜基质炎患者91例91眼,随机分为两组,A组应用10g/L环孢霉素A滴眼液和更昔洛韦凝胶,B组应用5g/L氯替泼诺滴眼液和更昔洛韦凝胶,其余均为对症治疗,随诊观察6～12(平均10)mo。结果:两组治疗单疱病毒性角膜基质炎疗效无显著性差异,但A组治愈时间平均5.1±2.4d,B组治愈时间平均6.2±2.8d,A组较B组平均治愈时间短。两组治愈率及复发率无统计学差异。结论:对于单疱病毒性角膜基质炎患者应用10g/L环孢霉素A滴眼液能够安全有效治愈,且治愈时间短。     

小牛血去蛋白眼用凝胶治疗角膜上皮缺损的临床观察

目的：评价200 g/L小牛血去蛋白眼用凝胶治疗持续性角膜上皮缺损的临床疗效。 方法：观察持续性角膜上皮缺损患者168例（包括单疱病毒性角膜炎上皮型58例;化学烧伤24例;胬肉手术术后86例）,随机分成小牛血去蛋白眼用凝胶组（84例）,碱性成纤维细胞生长因子眼用凝胶组（ bFGF,84例）。两组均滴眼4次/d,共7d。观察上皮缺损修复和患眼局部症状、体征等指标。 结果：小牛血去蛋白眼用凝胶组和bFGF组疗效判断指标较治疗前皆有显著性差异（P〈0.01）。小牛血去蛋白眼用凝胶组有效率（83.3%）高于bFGF组（69%）;治疗单疱病毒性角膜炎上皮型角膜炎、化学烧伤和手术所引起的有效率分别为72.4%,69.2%和95.2%;观察过程中未见局部刺激和全身不良反应。 结论：小牛血去蛋白眼用凝胶治疗持续性角膜上皮缺损疗效确切,安全性高。     

万B洛韦联合重组干扰素αIb治疗单疱病毒性角膜炎

目的　探讨万B洛韦联合重组干扰素αIb 治疗单疱病毒性角膜炎的疗效。方法　对单疱病毒性角膜炎(HSK),按病情分为上皮型,浅基质型,深基质型三类。口服万B洛韦和重组干扰素αIb 滴眼液联合应用,与无环鸟苷滴眼液治疗单疱病毒性角膜炎对比观察。结果　联合用药组有效率达98.33% ,复发率明显低于无环鸟苷治疗组,两组治愈率差异非常显著( x 2= 6.98, P < 0.01)。结论　万B洛韦联合重组干扰素αIb 对无环鸟苷无效的病例,对伴有角膜溃疡的病例,能促进其角膜基质的修复和上皮生长,无过敏或毒性反应,提高了疗效,缩短了疗程,为临床治疗HSK 提供了一个新的途径     

阿糖胞苷与无环鸟苷联合免疫增强剂治疗单疱病毒性角膜炎

应用阿糖胞苷、无环鸟苷及免疫增强剂联合治疗２６例２９眼单疱病毒性角膜炎，其治愈率为８２．８％，就单疱病毒的特点，单疱病毒性角膜炎的药物治疗及药物作用机理简要讨论。     

土贝母皂甙对单疱病毒性角膜炎作用的实验研究

目的：通过动物试验评价土贝线皂甙（tubeimoside,Tu）治疗单疱病毒性角膜炎（herpes simplex keratitis,HSK）的效果及滴眼刺激性。方法：在地鼠肾BHK－21传代细胞上进行单纯疱疹病毒－1型（herpes simplex virus-1,HSV-1）SM44毒株复苏，制作兔HSK模型，采用裂隙灯显微镜，扫描电镜和透射电镜观察眼部病变的动态变化评价Tu疗效，同时进行实验评价Tu滴眼刺激性。结果：Tu联合应用贝复舒或无环鸟苷可以提高Tu疗效，Tu提前用药类似于联合应用贝复舒。0．1g.L^-1Tu与生理盐水眼刺激分值的统计学结果无显著性差异。结论：Tu治疗实验性HSK有一定的疗效，对HSK具有预防作用，联合应用无环鸟苷不能增强无环鸟苷抗病毒能力，联合应用贝复舒可以增强Tu治疗，治疗HSK的疗效，0．1g.L^-1Tu滴眼无刺激性。     

丙氧鸟苷治疗单疱性角膜炎的临床研究

比较观察丙氧鸟苷与无环鸟苷两种滴眼剂治疗单疱性角膜炎３４例，两者疗效相似。树枝状角膜炎组两种药物的显效率分别为６３．６４％和７２．７３％，有效率分别为９０．９１％和８１．８２％。单疱性角膜炎总显效率分别为４７．０６％和５８．８２％，有效率均为８２．４％。扩大临床类型，用丙氧鸟苷共治疗单疱性角膜炎４５例，显效率为６４．４４％，有效率为８８．９％。本研究结果表明，丙氧鸟苷是一种治疗单疱性角膜炎的有效抗病毒制剂。     

无环鸟苷联合干扰素，双氯芬酸钠治疗单纯疱疹病毒性角膜炎

目的：观察无环鸟苷联合干扰素,双氯芬酸钠治疗单纯疱疹病毒性角膜炎的效果。方法：对160例（186眼）患者随机分为治疗组80例（97眼）和对照组80例（89例）治疗组患者滴0．1％无环鸟苷滴眼液,重组干扰素α1b滴眼液（10μg/ml）、0．1％双氯芬酸钠滴眼液,对照组滴用0．1％无环鸟苷滴眼液,结果：治疗组治愈率（91．75％）,对照治愈率（75．28％）经统计学处理,差异有显著意义（P＜0．01）;治疗组有效率（96．90％,对照组有效率（88．75％）,差异有显著意义（P＜0．05）,结论：无环鸟苷联合干扰素,双氯芬酸钠治疗单纯疱疹病毒性角膜炎疗效肯定,治愈率高,是合理安全的用药方法。     

球结膜下注射干扰素治疗单疱病毒性角膜炎36例

目的 探讨干扰素治疗单疱病毒性角膜炎的疗效。方法 明确诊断单疱病毒性角膜炎36例42眼,随机分为观察组和对照组,观察组21眼应用干扰素球结膜下注射治疗,对照组21眼应用普通药物治疗,3个疗程后观察结果。结果 观察组患者的视力恢复明显高于对照组,有效率达95％。结论 与其它治疗方法相比,应用干扰素球结膜下注射治疗单疱病毒性角膜炎有显著疗效。     

复方无环鸟苷滴眼剂治疗单疱角膜炎

应用复方无环鸟苷滴眼剂(简称ACF)治疗单疱角膜炎103例(109眼)其中浅层型27眼,深层型82眼,27眼合并角膜溃疡。点用ACF,治愈81眼、有效18眼,有效率为90.8%,治愈率为74.3%,平均治愈天数为浅层型12.4天、深层型21.5天。经8～18个月随访复发8例,复发率为8.7%,临床效果显著,讨论了复方抗单疱病毒药物与微量地塞米松的联合应用,强调“微量激素”对单疱角膜炎治疗的重要意义。     

Immunofluorescent staining and corneal sensitivity in patients suspected of having herpes simplex keratitis.

We examined immunofluorescent staining and corneal sensitivity in 25 control subjects (25 eyes) with normal corneas, six patients (eight eyes) with possible herpes simplex keratitis, and 44 patients (48 eyes) with corneal lesions (recurrent erosion, superficial punctate keratitis, marginal ulcer, and follicular keratoconjunctivitis) in whom herpes simplex keratitis was not suspected. On immunofluorescent staining, all 25 control subjects had negative reactions, all eight eyes suspected of having herpes simplex keratitis had positive reactions, and 11 (23%) of the 48 eyes not suspected of having herpes simplex keratitis had positive reactions; the remaining 37 eyes had negative reactions. Of the 11 eyes not suspected of having herpes simplex keratitis but that had positive reactions on immunofluorescent staining, nine had recurrent erosions and the remaining two eyes had superficial punctate keratitis. Of the eight eyes with possible herpes simplex keratitis, seven (88%) had decreased corneal sensitivity. Of the 11 eyes not suspected of having herpes simplex keratitis but that had positive reactions on immunofluorescent staining, eight (73%) had decreased corneal sensitivity. Of the 37 eyes not suspected of having herpes simplex keratitis that had negative reactions on immunofluorescent staining, 11 (30%) had decreased corneal sensitivity.     

Acyclic antimetabolite therapy of experimental herpes simplex keratitis.

In a masked controlled study we compared 3% acycloguanosine, 0.5% idoxuridine, and 3% vidarabine ointments in therapy of experimental herpes simplex virus keratitis in rabbits. The results of the acycloguanosine group were significantly better than the control groups and both other treatment groups, while producing none of the toxic side effects of increasing iritis, conjunctivitis or stromal keratitis, with continued drug application.     

Effects of topical unoprostone and latanoprost on acute and recurrent herpetic keratitis in the rabbit

PURPOSE: To determine the effect of the topical ocular hypotensive drug, isopropyl unoprostone, a docosanoid molecule with very weak prostaglandin activity, on herpes keratitis in the rabbit eye. METHODS: For acute disease, rabbit corneas inoculated with the corticosteroid-sensitive F(MP)E strain of herpes simplex virus type 1 were treated with various combinations of 0.12% isopropyl unoprostone, latanoprost, trifluridine, benzalkonium chloride 0.02%, dexamethasone sodium phosphate, ketorolac tromethamine, or saline solution beginning 1 day after infection. Severity of keratitis was evaluated in a masked manner. For recurrent disease, rabbit corneas infected with McKrae strain herpes simplex virus type 1 were treated with unoprostone or saline solution on postinfection days 25 to 42, and the presence or absence of lesions was recorded. RESULTS: Eyes treated with unoprostone showed significantly less severe disease than saline-treated or latanoprost-treated eyes during acute infection. Unoprostone-treated and saline-treated eyes showed no significant difference in the frequency of recurrent lesions. Eyes treated with latanoprost and/or dexamethasone, separately or in combination, showed increased severity of acute herpes simplex virus keratitis, whereas benzalkonium chloride 0.02%--treated eyes showed no significant difference, compared with saline treatment. Trifluridine resulted in rapid healing. CONCLUSIONS: Unoprostone did not increase the severity or recurrence rate of herpes simplex virus keratitis. Unoprostone requires twice-a-day administration, compared with once-a-day for latanoprost, and unoprostone lowers intraocular pressure less than latanoprost. Nevertheless, unoprostone's superior safety profile may make its use advantageous. Benzalkonium chloride alone did not make the keratitis worse.     

益气养血祛风法治疗复发性单纯疱疹病毒性角膜炎的临床观察

目的:观察运用益气养血祛风法(黑睛退翳汤)治疗复发性单纯疱疹病毒性角膜炎(HSK)的临床疗效.方法:入选复发的HSK患者58例,随机分为治疗组和对照组.对照组给予重组人干扰素α-2b滴眼液和更昔洛韦眼用凝胶,对于具有虹膜睫状体炎症及角膜内皮炎症的患者给予复方托吡卡胺滴眼液散瞳治疗,酌情给予氟米龙滴眼液滴眼;治疗组在对照组的基础上加用黑睛退翳汤治疗4wk,观察两组临床疗效及治愈的患者治愈后6mo内疾病复发率情况.结果:两组患者治疗后临床疗效、疾病复发率比较差异均有统计学意义(P<0.05),治疗1 mo后,治疗组CD4+及CD4+/CD8+比值明显升高,均显著高于对照组(P<0.01),治疗组CD8+比例显著降低,与对照组比较差异显著(P<0.01).结论:益气养血祛风法中药黑睛退翳汤联合常规抗病毒西药治疗,能更好地治疗HSK并预防其复发,提高临床疗效,改善患者生活质量.     

Light adaptation and the luminance-response function of the cone electroretinogram

Corneal graft survival in 13 patients (14 eyes) receiving oral acyclovir following corneal transplantation for herpes simplex keratitis was compared to that in nine patients (9 eyes) who underwent penetrating keratoplasty for herpes simplex keratitis without receiving postoperative acyclovir. Mean age, duration of disease, and time of follow-up did not differ in the two groups. There were no recurrences of herpes simplex keratitis in any patient receiving acyclovir during a mean follow-up of 16.5 months compared to a 44% (4/9) recurrence rate in patients without acyclovir during a mean follow-up of 20.6 months (p < 0.01). Graft failure occurred in 14% (2/14) of acyclovir treatment eyes and in 56% (5/9) of the grafts in patients not receiving acyclovir. Long term prophylactic oral acyclovir significantly decreased the recurrence of herpes simplex keratitis and reduced corneal graft failure in patients with a history of recurrent herpes simplex keratitis who underwent corneal transplantation.Abbreviations ACV acyclovir - HSK herpes simplex keratitis - PK penetrating keratoplasty Presented as a paper at The American Academy of Ophthalmology, annual meeting in Anaheim, California 13–17 October 1991.     

Geldanamycin is effective in the treatment of herpes simplex virus epithelial keratitis in a rabbit model

Background: To evaluate the efficacy of geldanamycin eye drops against herpes simplex virus epithelial keratitis in a rabbit model. Methods: New Zealand white rabbits were randomized into four groups and infected with herpes simplex virus type 1; geldanamycin topical eye drops was initiated 24 h after the infection and maintained for 12 consecutive days. Four groups of rabbits received 5 µg/mL geldanamycin, 10 µg/mL geldanamycin, 0.1% acyclovir and escipient (a kind of artificial tears), respectively. The severity of herpes simplex virus type 1 epithelial keratitis was measured by slit‐lamp and scored for statistics analysis. The virus shedding in eye swabs was isolated, and tissue culture infective dose (TCID₅₀) was determined. Results: Geldanamycin (10 µg/mL) treatment reduced significantly the severity of herpes simplex virus type 1 epithelial keratitis than the other three groups. Geldanamycin (5 µg/mL) was as effective as acyclovir (0.1%) treatment. The effect of geldanamycin against herpes simplex virus type 1 epithelial keratitis correlated with accelerated clearance of virus of the rabbits. Conclusion: Geldanamycin is a promising treatment option against herpes simplex virus type 1 epithelial keratitis. Geldanamycin (10 µg/mL) is better than acyclovir and geldanamycin (5 µg/mL) in the rabbit model. The optimal concentration of this drug in human is still to be determined.     

单纯疱疹病毒性角膜炎药物联合治疗的临床观察

目的评价华蟾素联合阿糖胞苷注射液和无环鸟苷滴眼液治疗单纯疱疹病毒性角膜炎的疗效。方法将186例(200只眼)单纯疱疹性病毒角膜炎患者随机分为治疗组106例和对照组94例,治疗组采用静脉滴注华蟾素、结膜下注射阿糖胞苷注射液和结膜囊滴用无环鸟苷滴眼液联合治疗。对照组采用上述三种治疗方法中的一种或两种。结果治疗组第一疗程治疗时间最长10天,最短3天,平均6天痊愈,治愈率为94.3％,而对照组治疗时间最长40天,最短7天,平均15．2天,治愈率为64．9％,两组相比差异有显著性(P<0．05)。结论本方法能明显缩短疗程,减少瘢痕形成,提高治愈率。