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The Herpetic Eye Disease Study

The Herpetic Eye Disease Study Abstract There are an estimated 500 000 episodes of eye disease with herpes simplex virus in the United States each year, and herpetic infections of the eye are a major cause of corneal opacity and visual loss.1 There is still considerable controversy, even among knowledgeable ophthalmologists, on the optimal management of herpetic eye disease. While topical antivirals, such as trifluridine, are effective in treating herpetic ulceration of the corneal epithelium, these drugs do not control disease in the deeper structures of the eye. Herpetic stromal keratitis and iridocyclitis are often treated with corticosteroids to suppress the inflammatory response. Local steroids, however, enhance recurrences of infectious herpetic epithelial keratitis and are implicated in prolonging the course of the disease, increasing its severity, and predisposing to secondary complications, such as corneal perforation.2-8 The development of the potent, specific, antiviral acyclovir, particularly the oral form, has dramatically changed the clinical approach to References 1. External Ocular Infections and Inflammatory Disease. In: Vision Research: A National Plan 1983-1987 . Washington, DC: National Eye Institute; 1983. US Dept of Health and Human Services publication NIH 83-2472. 2. Patterson N, Jones BR. The management of ocular herpes . Eye . 1967;87:59-84. 3. Sundmacher R. Trifluorthymidinprophylaxe bei der Steroidtherapie herpetischer Keratouveitiden . Klin Monatsbl Augenheilkd . 1973;173:516-519. 4. Boruchoff SA. Steroids in herpes simplex keratitis . In: Brockhurst RJ, Boruchoff SA, Hutchinson BR, Lessell S, eds. Controversy in Ophthalmology . Philadelphia, Pa: WB Saunders Co; 1970:470-471. 5. Pavan-Langston D, Abelson MB. The role of steroids in ocular herpes . In: Brockhurst RJ, Boruchoff SA, Hutchinson BR, Lessell S, eds. Controversy in Ophthalmology . Philadelphia, Pa: WB Saunders Co; 1970:438-449. 6. Thygeson P. The unfavorable role of corticosteroids in herpetic keratitis . In: Brockhurst RJ, Boruchoff SA, Hutchinson BR, Lessell S, eds. Controversy in Ophthalmology . Philadelphia, Pa: WB Saunders Co; 1970:450-469. 7. Waring GO III. Glucocorticoid therapy in ocular herpes simplex, I: Ostler HB. Limitations; II: Pavan-Langston D, Abelson MB. Advantages . Surv Ophthalmol . 1978;23:35-48.Crossref 8. Wilhelmus KR. The management of herpetic eye disease . In: Koch DD, Packer DW, Paton D, eds. Current Management in Ophthalmology . New York, NY: Churchill Livingstone Inc; 1983:1-24. 9. Crowe S, Mills J. Chemotherapy of herpesvirus infections: present successes and future hopes . Eur J Clin Microbiol . 1989;4:459-463.Crossref 10. Cobo LM, Foulks GN, Liesegang T, et al. Oral acyclovir in the treatment of acute herpes zoster ophthalmicus . Ophthalmology . 1986;93:763-70.Crossref 11. Sundmacher R. Orale Acyclovir-Therapie virologisch nachgewiesener intraokularer Herpes simplex Virus Infektionen . Klin Monatsbl Augenheilkd . 1983;183:246-250.Crossref 12. Sanitato JJ, Asbell PA, Varnell ED, Kissling GE, Kaufman HE. Acyclovir in the treatment of herpetic stromal disease . Am J Ophthalmol . 1984;98:537-547. 13. Bialasiewicz AA, Jahn GJ. Systemische Acyclovir-Therapie bei rejidivierender durch Herpes simplex virus bedingter Keratouveitis . Klin Monatsbl Augenheilkd . 1984;185:539-542.Crossref 14. Schwab IR. Oral acyclovir in the management of herpes simplex ocular infections . Ophthalmology . 1988;95:423-430.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

The Herpetic Eye Disease Study

Archives of Ophthalmology , Volume 108 (2) – Feb 1, 1990

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Publisher
American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1990.01070040043027
Publisher site
See Article on Publisher Site

Abstract

Abstract There are an estimated 500 000 episodes of eye disease with herpes simplex virus in the United States each year, and herpetic infections of the eye are a major cause of corneal opacity and visual loss.1 There is still considerable controversy, even among knowledgeable ophthalmologists, on the optimal management of herpetic eye disease. While topical antivirals, such as trifluridine, are effective in treating herpetic ulceration of the corneal epithelium, these drugs do not control disease in the deeper structures of the eye. Herpetic stromal keratitis and iridocyclitis are often treated with corticosteroids to suppress the inflammatory response. Local steroids, however, enhance recurrences of infectious herpetic epithelial keratitis and are implicated in prolonging the course of the disease, increasing its severity, and predisposing to secondary complications, such as corneal perforation.2-8 The development of the potent, specific, antiviral acyclovir, particularly the oral form, has dramatically changed the clinical approach to References 1. External Ocular Infections and Inflammatory Disease. In: Vision Research: A National Plan 1983-1987 . Washington, DC: National Eye Institute; 1983. US Dept of Health and Human Services publication NIH 83-2472. 2. Patterson N, Jones BR. The management of ocular herpes . Eye . 1967;87:59-84. 3. Sundmacher R. Trifluorthymidinprophylaxe bei der Steroidtherapie herpetischer Keratouveitiden . Klin Monatsbl Augenheilkd . 1973;173:516-519. 4. Boruchoff SA. Steroids in herpes simplex keratitis . In: Brockhurst RJ, Boruchoff SA, Hutchinson BR, Lessell S, eds. Controversy in Ophthalmology . Philadelphia, Pa: WB Saunders Co; 1970:470-471. 5. Pavan-Langston D, Abelson MB. The role of steroids in ocular herpes . In: Brockhurst RJ, Boruchoff SA, Hutchinson BR, Lessell S, eds. Controversy in Ophthalmology . Philadelphia, Pa: WB Saunders Co; 1970:438-449. 6. Thygeson P. The unfavorable role of corticosteroids in herpetic keratitis . In: Brockhurst RJ, Boruchoff SA, Hutchinson BR, Lessell S, eds. Controversy in Ophthalmology . Philadelphia, Pa: WB Saunders Co; 1970:450-469. 7. Waring GO III. Glucocorticoid therapy in ocular herpes simplex, I: Ostler HB. Limitations; II: Pavan-Langston D, Abelson MB. Advantages . Surv Ophthalmol . 1978;23:35-48.Crossref 8. Wilhelmus KR. The management of herpetic eye disease . In: Koch DD, Packer DW, Paton D, eds. Current Management in Ophthalmology . New York, NY: Churchill Livingstone Inc; 1983:1-24. 9. Crowe S, Mills J. Chemotherapy of herpesvirus infections: present successes and future hopes . Eur J Clin Microbiol . 1989;4:459-463.Crossref 10. Cobo LM, Foulks GN, Liesegang T, et al. Oral acyclovir in the treatment of acute herpes zoster ophthalmicus . Ophthalmology . 1986;93:763-70.Crossref 11. Sundmacher R. Orale Acyclovir-Therapie virologisch nachgewiesener intraokularer Herpes simplex Virus Infektionen . Klin Monatsbl Augenheilkd . 1983;183:246-250.Crossref 12. Sanitato JJ, Asbell PA, Varnell ED, Kissling GE, Kaufman HE. Acyclovir in the treatment of herpetic stromal disease . Am J Ophthalmol . 1984;98:537-547. 13. Bialasiewicz AA, Jahn GJ. Systemische Acyclovir-Therapie bei rejidivierender durch Herpes simplex virus bedingter Keratouveitis . Klin Monatsbl Augenheilkd . 1984;185:539-542.Crossref 14. Schwab IR. Oral acyclovir in the management of herpes simplex ocular infections . Ophthalmology . 1988;95:423-430.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Feb 1, 1990

References