Analysis of Clinical Manifestations and Prognostic Factors in Herpetic Endotheliitis

Hyeon Jeong Yoon; Yong Sok Ji; Kyung-Chul Yoon

doi:10.3341/jkos.2017.58.5.516

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Yoon, Ji, and Yoon: Analysis of Clinical Manifestations and Prognostic Factors in Herpetic Endotheliitis

Original Article

Journal of the Korean Ophthalmological Society 2017; 58(5): 516-522.

Published online: 15 May 2017

DOI: https://doi.org/10.3341/jkos.2017.58.5.516

Analysis of Clinical Manifestations and Prognostic Factors in Herpetic Endotheliitis

Hyeon Jeong Yoon, MD, Yong Sok Ji, MD, PhD, Kyung-Chul Yoon, MD, PhD

Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea.

Address reprint requests to Kyung-Chul Yoon, MD, PhD. Department of Ophthalmology, Chonnam National University Hospital, #42 Jebong-ro, Dong-gu, Gwangju 61469, Korea. Tel: 82-62-220-6753, Fax: 82-62-227-1642, kcyoon@jnu.ac.kr

Received 9 February 2017 Revised 14 March 2017 Accepted 25 April 2017

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Disciform keratitis, Herpetic endotheliitis

Figures and Tables

Table 1

Baseline characteristics of herpetic endotheliitis patients according to the type

Values are presented as mean ± standard deviation or n.

BCVA = best corrected visual acuity; logMAR = logarithm of the minimum angle of resolution; IOP = intraocular pressure; HTN = hypertension; DM = diabetes mellitus; CVA = cerebrovascular accident; PCR = polymerase chain reaction.

^*Student-t test; ^†Fisher's exact test.

Table 2

Clinical outcomes of herpetic endotheliitis patients according to the type at the final visit

Values are presented as mean ± standard deviation or n (%).

BCVA = best corrected visual acuity; logMAR = logarithm of the minimum angle of resolution; IOP = intraocular pressure.

^*Student-t test; ^†Fisher's exact test.

Table 3

Characteristics of the herpetic endotheliitis patients with recurrence at the first visit

Values are presented as number. Fisher's exact test.

Table 4

Factors affecting recurrence in herpetic endotheliitis by univariate and multivariate analysis

OR = odds ratio; CI = confidence interval; BCVA = best corrected visual acuity; logMAR = logarithm of the minimum angle of resolution; IOP = intraocular pressure.

Table 5

Characteristics of the herpetic endotheliitis patients with corneal decompensation at the first visit

Values are presented as number. Fisher's exact test.

Table 6

Factors affecting corneal decompensation in herpetic endotheliitis by univariate and multivariate analysis

OR = odds ratio; CI = confidence interval; BCVA = best corrected visual acuity; logMAR = logarithm of the minimum angle of resolution; IOP = intraocular pressure.

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