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Chapter 1 The Morphology of Varicella-Zoster Virus Epithelial Keratitis in Herpes Zoster Ophthalmicus |
VZV Epithelial Keratitis: Surface Elevations and Disruptions
Fig. 1.4 Incipient foci of VZV corneal epithelial infection (arrows) visualized with fluorescein sodium and blue filter. Elevated foci with intact surfaces appear dark; bright fluorescein staining indicates surface disruptions
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b
Fig. 1.5 (a) In the tear film stained green with fluorescein sodium, incipient VZV lesions located below an intact surface (arrows) appear dark. In the right lesion are visible grouped swollen/rounded cells (arrowhead). (b) In this part of a larger lesion, protruding swollen/rounded cells appear as dark dots (arrowheads) in the tear film stained green with fluorescein sodium
VZV Epithelial Keratitis: Dynamics of Fluorescein Sodium Staining |
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VZV Epithelial Keratitis: Dynamics of Fluorescein Sodium Staining
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Fig. 1.6 The same part of a larger VZV |
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corneal epithelial lesion. (The arrows |
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are placed in corresponding locations) |
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(a) Shortly after the application of |
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fluorescein |
sodium, the staining shows |
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a broken pattern; some areas appear |
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intensively green, others only weakly. |
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The white arrow indicates an area of a small incipient lesion, the black arrows point to small cysts
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(b) After a short while, with ongoing |
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diffusion, the staining is more pro- |
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nounced; the individual parts float |
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together, which gives rise to an impres- |
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sion of a continuous, branching figure |
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(c) A few minutes later is visible a |
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smooth, green stained branching fig- |
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ure with no discernible details except |
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for some cysts (brightly green dots). |
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Rose bengal reveals diseased surface |
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cells and cell debris; in places, the red |
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staining is confluent |