Fundus Change Following Herpes Zoster Ophthalmicus

眼部帶狀疱疹引起的眼底變化

黃介宏(Chieh-Hung Huang) ； 楊伯仁(Bao-Jen Yang) ； 陳玠元(Jei-Yuan Chern)

《中華民國眼科醫學會雜誌》 32卷3期 (1993/09) Pp. 371-376

https://doi.org/10.30048/ACTASOS.199309.0018

摘要

眼部帶狀疱疹所產生的眼底變化較少被記載。本文報告一個15歲男孩，患有全身散在性帶狀疱疹，包括左側三叉神經第一及第二分支。早期眼部表現為角膜炎及虹彩炎，隨後之眼底檢查，發現有多處特殊的散在性色素脫失區域，病灶位於脈胳膜及視網膜色素細胞層。此外，虹膜上亦可見多處萎縮之斑點。電生理學檢查顯示桿狀及錐狀細胞功能均受到影響。這種眼底變化，可能導因於感染病毒後局部脈胳膜缺血或發炎而引起。若與過去的病例報告相較，我們的病人顯得較為年輕，眼底變化之分佈範圍也略有不同；電生理學方面的研究，過去並未見有記載。詳盡的眼底檢查，對於眼部帶狀疱疹之病人不可忽略，對此種眼底病變的認識亦可減少診斷上的混淆，故提出報告。

並列摘要

The fundus change after herpes zoster infection was rarely documented. We present a case of 15 year-old boy, who sufferred from disseminated herpes zoster infection, involving the first and second branches of left trigeminal nerve. Keratitis and uveitis were noted as initial ocular manifestation. Fundus examination revealed characteristic multifocal depigmented patches at the level of choroid and retinal pigment epithelium. In addition, there were some iris atrophic patches in the affected eye. Electrophysiological study revealed impairment of both rod and cone cell functions. The picture of the fundus change may be the result of focal choroidal ischemia or choroidal inflammation caused by the herpes zoster virus infection. This may contribute to the unsatisfactory visual result in cases needing cataract surgery or penetrating keratoplasty following HZO. We should always remember to examine the fundus carefully whenever HZO occurs.

並列關鍵字

Herpes zoster ophthalmicus ； choroidal infarction ； Choroiditis ； Electrophysiology