콘택트렌즈 착용 후 발생한 수지상각막염: 임상 증례 및 문헌고찰
Dendritic Keratitis Associated with Contact Lens Wear: a Case Series and Literature Review
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목적: 저자들은 이전에 각막염으로 치료받은 과거력 없이 콘택트렌즈 사용 후 처음 발생한 수지상각막염의 7안의 증례들을 경험하고이를 단순포진바이러스각막염으로 진단하고 치료하였기에 문헌고찰과 함께 보고하고자 한다. 대상과 방법: 안과 외래에 2년간 방문한 환자들을 대상으로 콘택트렌즈 착용 후 수지상 각막병변을 보인 환자의 진단 및 치료와 경과 관찰을 시행하였다. 결과: 콘택트렌즈 착용 후 수지상 각막병변을 보인 7안의 환자에 관한 과거력 청취와 임상양상 및 분자생물학적 방법을 통한 진단 및 치료 기간 동안의 경과 관찰을 하였다. 결론: 콘택트렌즈 착용을 한 후 수지상각막염을 보이는 환자의 경우, 통상적인 비감염성 각막침윤이나 세균 및 진균에 의한 각막염이 아닌 단순포진바이러스각막염의 가능성도 있으므로 정확한 과거력 청취 및 임상적, 분자생물학적 진단이 필요하고, 경험적 항바이러스 치료에 대한 반응을 면밀히 살펴볼 필요가 있다.
Abstract
Purpose: We report seven cases of first occurrence of dendritic keratitis associated with contact lens wear without previous keratitishistory, based on a literature review. Those cases were finally diagnosed and treated as herpes virus keratitis. Methods: Among patients who visited the ophthalmology outpatient clinic over two years, patients with dendritic corneal lesionsassociated with contact lens wear were included. Authors performed the diagnosis, treatment and the clinical follow up. Results: Seven Patients with dendritic corneal lesions after wearing contact lens were diagnosed by history taking, clinical findingsand molecular biological methods and were observed over the course of treatment. Conclusions: For patients with dendritic keratitis after wearing contact lenses, there is a possibility of herpes keratitis rather thanthe common lesions associated with non-infectious corneal infiltration or keratitis caused by bacteria and fungus. It is necessaryto observe those eyes thoroughly in respect to the exact past history taking, diagnosis by molecular-biological method as well asclinical features and the response to empirical antiviral agents.
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