Short communication
Herpetic endotheliitis and trabeculitis with delayed corneal involvement
Endotelitis y trabeculitis herpética con afectación corneal tardía
I. Carrillo-Arroyo, E. Gutiérrez-Díaz, E. Mencía-Gutiérrez
, P. Gómez-Pérez, M. Montero-Rodríguez
Corresponding author
Servicio de Oftalmología, Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain
Read
3932
Timeswas read the article
584
Total PDF
3348
Total HTML
Share statistics
array:24 [ "pii" => "S2173579412000722" "issn" => "21735794" "doi" => "10.1016/j.oftale.2012.05.002" "estado" => "S300" "fechaPublicacion" => "2012-02-01" "aid" => "196" "copyright" => "Sociedad Española de Oftalmología" "copyrightAnyo" => "2011" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2012;87:47-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3939 "formatos" => array:3 [ "EPUB" => 12 "HTML" => 3346 "PDF" => 581 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0365669111003972" "issn" => "03656691" "doi" => "10.1016/j.oftal.2011.06.018" "estado" => "S300" "fechaPublicacion" => "2012-02-01" "aid" => "196" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2012;87:47-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 7460 "formatos" => array:3 [ "EPUB" => 20 "HTML" => 6442 "PDF" => 998 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Comunicación corta</span>" "titulo" => "Endotelitis y trabeculitis herpética con afectación corneal tardía" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "47" "paginaFinal" => "49" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Herpetic endotheliitis and trabeculitis with delayed corneal involvement" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 713 "Ancho" => 950 "Tamanyo" => 102803 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Imagen con tinción de fluoresceína que demuestra queratitis punctata y úlcera dendrítica herpética.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "I. Carrillo-Arroyo, E. Gutiérrez-Díaz, E. Mencía-Gutiérrez, P. Gómez-Pérez, M. Montero-Rodríguez" "autores" => array:5 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "Carrillo-Arroyo" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Gutiérrez-Díaz" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Mencía-Gutiérrez" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Gómez-Pérez" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Montero-Rodríguez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173579412000722" "doi" => "10.1016/j.oftale.2012.05.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579412000722?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669111003972?idApp=UINPBA00004N" "url" => "/03656691/0000008700000002/v1_201305021348/S0365669111003972/v1_201305021348/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173579412000710" "issn" => "21735794" "doi" => "10.1016/j.oftale.2012.05.001" "estado" => "S300" "fechaPublicacion" => "2012-02-01" "aid" => "177" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2012;87:50-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3153 "formatos" => array:3 [ "EPUB" => 13 "HTML" => 2787 "PDF" => 353 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Visual fields defect as initial presentation of neurosarcoidosis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "50" "paginaFinal" => "54" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Alteraciones campimétricas como manifestación inicial de una neurosarcoidosis" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0025" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 493 "Ancho" => 1281 "Tamanyo" => 98884 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Ocular fundus showing peripapillary atrophy and paleness in the temporal region of the RE and total paleness in the LE also with peripapillary atrophy in the temporal region.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.L. Maldonado-Morales, A. Ruiz-Calvo, E. Santos-Bueso, A. Del-Hierro, C. López-Abad, D. Díaz-Valle, J.M. Benítez-del-Castillo, J. García-Sánchez" "autores" => array:8 [ 0 => array:2 [ "nombre" => "M.L." "apellidos" => "Maldonado-Morales" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Ruiz-Calvo" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Santos-Bueso" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Del-Hierro" ] 4 => array:2 [ "nombre" => "C." "apellidos" => "López-Abad" ] 5 => array:2 [ "nombre" => "D." "apellidos" => "Díaz-Valle" ] 6 => array:2 [ "nombre" => "J.M." "apellidos" => "Benítez-del-Castillo" ] 7 => array:2 [ "nombre" => "J." "apellidos" => "García-Sánchez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669111003728" "doi" => "10.1016/j.oftal.2011.06.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669111003728?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579412000710?idApp=UINPBA00004N" "url" => "/21735794/0000008700000002/v1_201305091034/S2173579412000710/v1_201305091034/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S217357941200076X" "issn" => "21735794" "doi" => "10.1016/j.oftale.2012.05.006" "estado" => "S300" "fechaPublicacion" => "2012-02-01" "aid" => "224" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2012;87:44-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1978 "formatos" => array:3 [ "EPUB" => 15 "HTML" => 1620 "PDF" => 343 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Intermediate uveitis due to human T-cell lymphotropic virus type 1" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "44" "paginaFinal" => "46" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Uveítis intermedia por virus linfotropo humano de células T Tipo 1" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 713 "Ancho" => 949 "Tamanyo" => 89034 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Right eye ocular fundus image showing the macular folds produced by the macular epiretinal membrane.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A.C. Millán-Rodríguez, C. Fernández-Cid, M. García-Campello, C. Sevillano, P.C. Fernández-Vila" "autores" => array:5 [ 0 => array:2 [ "nombre" => "A.C." "apellidos" => "Millán-Rodríguez" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Fernández-Cid" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "García-Campello" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Sevillano" ] 4 => array:2 [ "nombre" => "P.C." "apellidos" => "Fernández-Vila" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669111005144" "doi" => "10.1016/j.oftal.2011.06.022" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669111005144?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357941200076X?idApp=UINPBA00004N" "url" => "/21735794/0000008700000002/v1_201305091034/S217357941200076X/v1_201305091034/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Herpetic endotheliitis and trabeculitis with delayed corneal involvement" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "47" "paginaFinal" => "49" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "I. Carrillo-Arroyo, E. Gutiérrez-Díaz, E. Mencía-Gutiérrez, P. Gómez-Pérez, M. Montero-Rodríguez" "autores" => array:5 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "Carrillo-Arroyo" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Gutiérrez-Díaz" ] 2 => array:4 [ "nombre" => "E." "apellidos" => "Mencía-Gutiérrez" "email" => array:2 [ 0 => "emencia.hdoc@salud.madrid.org" 1 => "emenciag@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Gómez-Pérez" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Montero-Rodríguez" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Oftalmología, Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Endotelitis y trabeculitis herpética con afectación corneal tardía" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 708 "Ancho" => 933 "Tamanyo" => 100940 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Appearance of the anterior segment in the first assessment in the practice, showing the ciliary injection and slight corneal edema.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">In 1982 Khodadoust and Attarzadeh defined the autoimmune corneal endotheliopathy, characterized by a stromal edema that progress inwardly from the periphery.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It was subsequently proven that this endotheliopathy was caused by the herpes simplex virus (HSV). Herpetic keratitis is a complex ocular disease with highly variable forms of expression. Trabeculitis is defined by some authors as a preferred variant of endotheliitis while others consider it a form of herpetic uveitis.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> It appears that the physiopathological mechanism consists of an obstruction of the aqueous humor drainage by inflammatory cells and occasionally trabecular scarring with persistent glaucoma. Increased intraocular pressure (IOP) generally responds to topical corticoids treatment, making filtrating surgery frequently unnecessary.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Clinic case</span><p id="par0010" class="elsevierStylePara elsevierViewall">A male, aged 62, visited the practice due to painless diminished visual acuity (VA) in the left eye (LE) with 2 days of evolution. The patient had visited 2 months earlier due to red eye, diagnosed as conjunctivitis and treated with a fixed combination of dexamethasone and tobramycin. At that time, the VA was of 1 and IOP of 14<span class="elsevierStyleHsp" style=""></span>mmHg in both eyes. Personal history of the patients included diabetes mellitus, arterial hypertension, obesity, hepatic steatosis, hyperthyroidism, ischemic cardiopathy and kidney transplant due to chronic renal insufficiency secondary to chronic pyelonephritis. The systemic and medical treatment included prednisone 5<span class="elsevierStyleHsp" style=""></span>mg/24<span class="elsevierStyleHsp" style=""></span>h (Prednisona Alonga<span class="elsevierStyleSup">®</span>, Sanofi Aventis), tachrolimus (Prograf<span class="elsevierStyleSup">®</span>, MSD) and mycophenolate mofetil (Cellcept<span class="elsevierStyleSup">®</span>, Roche).</p><p id="par0015" class="elsevierStylePara elsevierViewall">The initial exploration gave a VA of 1 in the right eye (RE) and 0.1 in LE, normal biomicroscopy in RE with intense conjunctival injection in LE and lackluster corner with central predominance with slight edema and negative fluorescein staining, without Tyndall, synechiae, keratic precipitates or secretion. IOP was of 18<span class="elsevierStyleHsp" style=""></span>mmHg in RE and 46<span class="elsevierStyleHsp" style=""></span>mmHg in LE. The ocular fundus could be seen with difficulty due to the corneal edema, but the papilla and the macular were normal with the retina applied without peripheral lesions. The gonioscopy showed open angle without synechiae or neovessels. During the exploration, we observed that the patient was drowsy and had difficulty breathing, in addition to exhibiting low height, moderate obesity and a short neck.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The initial diagnosis was ocular hypertension in LE, and treatment was established with a fixed combination of 0.2% brimonidine and 0.5% timolole maleate (Combigan<span class="elsevierStyleSup">®</span>, Allergan). The patient was referred to the glaucoma and neurology services where he was subsequently diagnosed with severe apnea-hypopnea syndrome.</p><p id="par0025" class="elsevierStylePara elsevierViewall">One week later, the VA remained at 0.1 with persisting conjunctival hyperemia, slight corneal edema, slight superficial keratitis punctata, with IOP at 40<span class="elsevierStyleHsp" style=""></span>mmHg (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Pachymetry was 512<span class="elsevierStyleHsp" style=""></span>μm in RE and 574<span class="elsevierStyleHsp" style=""></span>μm in LE (this increase was explained by the corneal edema). A differential diagnosis was proposed with a carotid-cavernous fistula or an orbitary apex syndrome and a computerized axial tomography (CAT) was requested. The treatment was changed to brinzolamide (Azopt<span class="elsevierStyleSup">®</span>, Alcon Cusi), tafluprost (Saflutan<span class="elsevierStyleSup">®</span>, MSD) and sodium diclofenac (Diclofenaco-lepori<span class="elsevierStyleSup">®</span>, Angelini Farmacéutica). Two days later, the IOP remained at 30<span class="elsevierStyleHsp" style=""></span>mmHg and therefore acetazolamide was added (Edemox<span class="elsevierStyleSup">®</span>, Chiesi-Spain) and oral prednisone 60<span class="elsevierStyleHsp" style=""></span>mg (Prednisona Alonga<span class="elsevierStyleSup">®</span>, Sanofi Aventis).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The hyperemia diminished progressively (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), and the corticoids dosage was gradually reduced although the IOP remained above 26<span class="elsevierStyleHsp" style=""></span>mmHg. The CAT discarded any orbitary and/or cranial disease. Five weeks later a peripheral ulcer emerged with pseudodendritic appearance which gave positive fluorescein staining with infiltration of edges. A corneal sample was taken for culture and detection of proteins C reactive to virus herpes (<a class="elsevierStyleCrossRefs" href="#fig0015">Figs. 3 and 4</a>), initiating treatment with topical aciclovir (Zovirax<span class="elsevierStyleSup">®</span>, Glaxo Smith Kline) and oral aciclovir (Virex<span class="elsevierStyleSup">®</span>, Biogen). The microbiological analysis was positive for HSV. With said treatment, the corneal lesion closed leaving a small peripheral leukoma, the IOP returned to normal values and the visual acuity reached 0.8.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">The definitive diagnosis of our case was endotheliitis and trabeculitis with secondary ocular hypertension and epithelial involvement in the form of late corneal ulcer. The absence of clear signs caused a delay in the diagnosis which became obvious when the corneal alteration emerged, with microbiological confirmation and the favorable response to the treatment.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Ohashi et al.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> proposed the hypotheses that, in each reactivation, the HSV latent in the trigeminal ganglion could traverse said nerve and reach the trabecular mesh from where copies of the virus would be secreted to the other ocular structures. These hypotheses are supported by the onset of the corneal edema in the periphery, the presence of HSV DNA in the aqueous humor of patients with endotheliitis and immunoreactivity for HSV described in the <span class="elsevierStyleItalic">trabeculum</span> of a patient intervened with trabeculectomy due to a secondary glaucoma of this type.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> It has also been postulated that the cicatrization of the trabecular mesh would be associated to a certain degree of necrosis produced directly by the virus similar to the iris atrophy or the necrotizing stromal keratitis.</p><p id="par0045" class="elsevierStylePara elsevierViewall">In our case, the absence of keratic precipitates, ocular pain and typical epithelial or endothelial injuries made the diagnosis difficult, although the multiple pathologies should have suggested an evident possibility, i.e., a recurring and opportunistic infection in an immunodepressed patient. Erroneously we considered that the corneal edema was explained by the increased IOP although the sequence was the contrary: an endotheliitis that caused corneal edema accompanied by trabeculitis which increased ocular pressure. With the diagnostic suspicion of herpetic endotheliitis and trabeculitis, treatment with antivirals and corticoids must be established without delay because the response is generally quick and prevents possible cicatricial lesions.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflict of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:2 [ "identificador" => "xres152679" "titulo" => array:3 [ 0 => "Abstract" 1 => "Case report" 2 => "Discussion" ] ] 1 => array:2 [ "identificador" => "xpalclavsec140679" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres152680" "titulo" => array:3 [ 0 => "Resumen" 1 => "Caso clínico" 2 => "Discusión" ] ] 3 => array:2 [ "identificador" => "xpalclavsec140680" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinic case" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2011-04-11" "fechaAceptado" => "2011-06-29" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec140679" "palabras" => array:5 [ 0 => "Endotheliitis" 1 => "Trabeculitis" 2 => "Herpes simplex virus" 3 => "Cornea" 4 => "Glaucoma" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec140680" "palabras" => array:5 [ 0 => "Endotelitis" 1 => "Trabeculitis" 2 => "Virus del herpes simple" 3 => "Córnea" 4 => "Glaucoma" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Case report</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A 62-year-old man with previous renal transplant and immunosuppressive treatment presented with decreased visual acuity (20/100) in his left eye, corneal edema and intraocular pressure of 46<span class="elsevierStyleHsp" style=""></span>mmHg. One month later an inferior marginal dendritic keratitis appeared. Corneal scraping and real-time polymerase chain reaction showed herpes simplex virus (HSV).</p> <span class="elsevierStyleSectionTitle">Discussion</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The autoimmune corneal endotheliopathy or acute idiopathic corneal endotheliitis is characterized by corneal stromal edema and keratic precipitates. HSV might be secreted from the trabeculum, innervated by the trigeminal nerve. This hypothesis is supported by the clinical observation that the corneal stromal edema usually starts from the periphery.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Caso clínico</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Varón de 62 años de edad con trasplante renal y tratamiento inmunosupresor que acude por disminución de la visión (20/100) en ojo izquierdo, edema corneal y presión intraocular de 46<span class="elsevierStyleHsp" style=""></span>mmHg. Un mes después aparece queratitis dendrítica marginal inferior. El raspado corneal y la proteína C reactiva demuestran la presencia de un virus del herpes simple (HVS).</p> <span class="elsevierStyleSectionTitle">Discusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La epiteliopatía corneal autoinmunitaria o endotelitis idiopática corneal se caracteriza por edema corneal y precipitados queráticos. Se cree que el HVS podría ser secretado desde el <span class="elsevierStyleItalic">trabeculum</span>, inervado por el nervio trigémino, apoyado clínicamente por la progresión del edema estromal desde la periferia.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Carrillo-Arroyo I, et al. Endotelitis y trabeculitis herpética con afectación corneal tardía. Arch Soc Esp Oftalmol. 2012;87:47–9.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 708 "Ancho" => 933 "Tamanyo" => 100940 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Appearance of the anterior segment in the first assessment in the practice, showing the ciliary injection and slight corneal edema.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 710 "Ancho" => 945 "Tamanyo" => 115501 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">One week later the reduction of the hyperemia is apparent.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 711 "Ancho" => 940 "Tamanyo" => 119121 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">At week 5 the conjunctival hyperemia persisted and a corneal dendritic injury appeared.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 708 "Ancho" => 938 "Tamanyo" => 117173 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Fluorescein stained image showing keratitis punctata and herpetic dendritic ulcer.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Presumed autoinmune corneal endotheliopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.A. Khodadoust" 1 => "A. Attarzadeh" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Ophthamol" "fecha" => "1982" "volumen" => "93" "paginaInicial" => "718" "paginaFinal" => "722" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Classification of herpes simplex virus keratitis and anterior uveitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "T.J. Liesegang" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cornea" "fecha" => "1999" "volumen" => "18" "paginaInicial" => "127" "paginaFinal" => "147" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10090358" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidence and prognosis of ocular hypertension secondary to viral uveitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G.K. Sungur" 1 => "D. Hazirolan" 2 => "I.S. Yalvac" 3 => "P.A. Ozer" 4 => "B.S. Aslan" 5 => "S. Duman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10792-009-9305-z" "Revista" => array:6 [ "tituloSerie" => "Int Ophthalmol" "fecha" => "2010" "volumen" => "30" "paginaInicial" => "191" "paginaFinal" => "194" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19343275" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Demonstration of herpes simplex virus DNA in idiopathic corneal endotheliopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Ohashi" 1 => "S. Yamamoto" 2 => "K. Nishida" 3 => "S. Okamoto" 4 => "S. Kinoshita" 5 => "K. Hayashi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Ophthalmol" "fecha" => "1991" "volumen" => "112" "paginaInicial" => "419" "paginaFinal" => "423" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1656756" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Herpes Simplex virus in the trabeculum of an eye with corneal endotheliitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Amano" 1 => "T. Oshika" 2 => "Y. Kaji" 3 => "J. Numaga" 4 => "M. Matsubara" 5 => "M. Araie" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Ophthalmol" "fecha" => "1999" "volumen" => "127" "paginaInicial" => "721" "paginaFinal" => "722" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10372885" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000008700000002/v1_201305091034/S2173579412000722/v1_201305091034/en/main.assets" "Apartado" => array:4 [ "identificador" => "5812" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Short communications" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000008700000002/v1_201305091034/S2173579412000722/v1_201305091034/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579412000722?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 2 | 3 | 5 |
| 2018 March | 2 | 0 | 2 |
| 2018 February | 18 | 0 | 18 |
| 2018 January | 31 | 4 | 35 |
| 2017 December | 26 | 0 | 26 |
| 2017 November | 40 | 3 | 43 |
| 2017 October | 43 | 5 | 48 |
| 2017 September | 43 | 3 | 46 |
| 2017 August | 23 | 3 | 26 |
| 2017 July | 42 | 4 | 46 |
| 2017 June | 39 | 9 | 48 |
| 2017 May | 62 | 0 | 62 |
| 2017 April | 57 | 4 | 61 |
| 2017 March | 46 | 30 | 76 |
| 2017 February | 97 | 4 | 101 |
| 2017 January | 53 | 0 | 53 |
| 2016 December | 86 | 14 | 100 |
| 2016 November | 102 | 9 | 111 |
| 2016 October | 105 | 18 | 123 |
| 2016 September | 82 | 9 | 91 |
| 2016 August | 72 | 2 | 74 |
| 2016 July | 87 | 7 | 94 |
| 2016 June | 90 | 14 | 104 |
| 2016 May | 76 | 22 | 98 |
| 2016 April | 104 | 15 | 119 |
| 2016 March | 87 | 17 | 104 |
| 2016 February | 75 | 17 | 92 |
| 2016 January | 81 | 19 | 100 |
| 2015 December | 70 | 24 | 94 |
| 2015 November | 90 | 14 | 104 |
| 2015 October | 84 | 24 | 108 |
| 2015 September | 42 | 13 | 55 |
| 2015 August | 79 | 25 | 104 |
| 2015 July | 111 | 16 | 127 |
| 2015 June | 61 | 26 | 87 |
| 2015 May | 64 | 20 | 84 |
| 2015 April | 69 | 20 | 89 |
| 2015 March | 78 | 12 | 90 |
| 2015 February | 58 | 4 | 62 |
| 2015 January | 56 | 9 | 65 |
| 2014 December | 75 | 15 | 90 |
| 2014 November | 46 | 12 | 58 |
| 2014 October | 74 | 12 | 86 |
| 2014 September | 55 | 11 | 66 |
| 2014 August | 57 | 16 | 73 |
| 2014 July | 48 | 9 | 57 |
| 2014 June | 46 | 7 | 53 |
| 2014 May | 50 | 9 | 59 |
| 2014 April | 39 | 11 | 50 |
| 2014 March | 32 | 8 | 40 |
| 2014 February | 25 | 6 | 31 |
| 2014 January | 26 | 4 | 30 |
| 2013 December | 34 | 4 | 38 |
| 2013 November | 42 | 2 | 44 |
| 2013 October | 61 | 5 | 66 |
| 2013 September | 64 | 6 | 70 |
| 2013 August | 34 | 4 | 38 |
| 2013 July | 7 | 1 | 8 |
Show all
