[Herpes simplex virus isolations from the aqueous humor of patients suffering from focal iritis, endotheliitis, and prolonged disciform keratitis with glaucoma (author's transl)].
Aqueous humor from 33 herpes patients, 4 zoster patients, and 14 patients with etiologically unclear anterior uveitis was cultured for the presence of herpes viruses. Nine taps from 8 herpes patients with corneal endothelial disease and/or anterior uveitis yielded herpes simplex virus. In the case of one patient two taps were positive at 14 days' interval. Control cultures from the surface of conjunctiva and cornea were consistently virus-negative. Analysis of the virus-positive cases displayed three remarkable features: 1. Secondary glaucoma was uniformly present. This in itself is an indication for culturable herpes simplex virus in the aqueous. 2. Three clinical pictures could be differentiated biomicroscopically: focal iritis, peripheral endotheliitis, and prolonged disciform keratitis. 3. In a proportion of cases, tissue damage resulting from associated immune reactions seems to be more important for the functional outcome than tissue damage by viral cytolysis itself. After having tried several antiviral substances (trifluorothymidine topically, adeninearabinoside-monophosphate intravenously, human leukocyte interferon intramuscularly and intracamerally) we presently favour a topical combination therapy consisting of trifluorothymidine and steroids. This must be complemented by cycloplegics and--in cases of high intraocular pressure--by acetazolamide.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001082:Aqueous Humor / Q000382:microbiology*; D004727:Endothelium; D005901:Glaucoma / Q000209:etiology*; D006801:Humans; D007500:Iritis / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D007635:Keratitis, Dendritic / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D008297:Male; D008875:Middle Aged
Herpes-simplex-Virus-Isolierung aus dem Kammerwasser bei fokaler Iritis, Endotheliitis und langdauernder Keratitis disciformis mit Sekundärglaukom.