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Bilateral herpetic keratoconjunctivitis.
Ophthalmology 2003; 110(3):493-6O

Abstract

PURPOSE

To review the clinical characteristics and visual outcomes of patients with bilateral herpetic keratitis.

DESIGN

Retrospective, noncomparative, observational case series.

PATIENTS AND METHODS

A retrospective review of medical records of 544 patients with herpes simplex virus (HSV) eye disease treated between January 1996 and September 2001 was performed at the Department of Ophthalmology, University of Minnesota. Seven patients (1.3%) with bilateral herpetic keratoconjunctivitis were identified.

RESULTS

In these seven patients, the age at the initial onset of corneal disease ranged from 7 weeks to 46 years, with a median of 18 years and a mean of 19.3 years. Five patients had systemic atopy, and two patients had severe ocular rosacea. Systemic immune disorders were noted in two patients. Recurrent blepharoconjunctivitis was noted in 8 eyes (57%), epithelial keratitis in 12 eyes (85.7%), stromal keratitis in 9 eyes (64.3%), necrotizing stromal keratitis in 5 eyes (35.7%), and progressive endotheliitis in 2 eyes (14.2%). Corneal complications included opacification, neovascularization, and corneal thinning or perforation. Penetrating keratoplasty was performed in 1 eye, in which endophthalmitis subsequently developed and which required enucleation. Four patients with continued use of oral antiviral prophylaxis (acyclovir 400 mg twice daily) since September 1999 showed significant decreases in recurrence. The average remission in these four patients was 1.7 years. The visual acuity at the last follow-up was 20/40 or worse in 6 eyes (42.8%).

CONCLUSIONS

In contrast to unilateral HSV keratitis, our patients with bilateral herpetic corneal infections had underlying atopy or immune deviations and evinced more protracted clinical courses. Long-term prophylactic antiviral treatment has reduced the incidence of recurrence in this group of patients.

Authors+Show Affiliations

Department of Ophthalmology, University of Minnesota, 516 Delaware Street SE, Minneapolis, MN 55455, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12623810

Citation

Souza, Paula Márcia F., et al. "Bilateral Herpetic Keratoconjunctivitis." Ophthalmology, vol. 110, no. 3, 2003, pp. 493-6.
Souza PM, Holland EJ, Huang AJ. Bilateral herpetic keratoconjunctivitis. Ophthalmology. 2003;110(3):493-6.
Souza, P. M., Holland, E. J., & Huang, A. J. (2003). Bilateral herpetic keratoconjunctivitis. Ophthalmology, 110(3), pp. 493-6.
Souza PM, Holland EJ, Huang AJ. Bilateral Herpetic Keratoconjunctivitis. Ophthalmology. 2003;110(3):493-6. PubMed PMID: 12623810.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bilateral herpetic keratoconjunctivitis. AU - Souza,Paula Márcia F, AU - Holland,Edward J, AU - Huang,Andrew J W, PY - 2003/3/8/pubmed PY - 2003/3/26/medline PY - 2003/3/8/entrez SP - 493 EP - 6 JF - Ophthalmology JO - Ophthalmology VL - 110 IS - 3 N2 - PURPOSE: To review the clinical characteristics and visual outcomes of patients with bilateral herpetic keratitis. DESIGN: Retrospective, noncomparative, observational case series. PATIENTS AND METHODS: A retrospective review of medical records of 544 patients with herpes simplex virus (HSV) eye disease treated between January 1996 and September 2001 was performed at the Department of Ophthalmology, University of Minnesota. Seven patients (1.3%) with bilateral herpetic keratoconjunctivitis were identified. RESULTS: In these seven patients, the age at the initial onset of corneal disease ranged from 7 weeks to 46 years, with a median of 18 years and a mean of 19.3 years. Five patients had systemic atopy, and two patients had severe ocular rosacea. Systemic immune disorders were noted in two patients. Recurrent blepharoconjunctivitis was noted in 8 eyes (57%), epithelial keratitis in 12 eyes (85.7%), stromal keratitis in 9 eyes (64.3%), necrotizing stromal keratitis in 5 eyes (35.7%), and progressive endotheliitis in 2 eyes (14.2%). Corneal complications included opacification, neovascularization, and corneal thinning or perforation. Penetrating keratoplasty was performed in 1 eye, in which endophthalmitis subsequently developed and which required enucleation. Four patients with continued use of oral antiviral prophylaxis (acyclovir 400 mg twice daily) since September 1999 showed significant decreases in recurrence. The average remission in these four patients was 1.7 years. The visual acuity at the last follow-up was 20/40 or worse in 6 eyes (42.8%). CONCLUSIONS: In contrast to unilateral HSV keratitis, our patients with bilateral herpetic corneal infections had underlying atopy or immune deviations and evinced more protracted clinical courses. Long-term prophylactic antiviral treatment has reduced the incidence of recurrence in this group of patients. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/12623810/Bilateral_herpetic_keratoconjunctivitis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(02)01772-4 DB - PRIME DP - Unbound Medicine ER -