Visual outcome in herpes simplex virus and varicella zoster virus uveitis: a clinical evaluation and comparison.
OBJECTIVE
To compare clinical characteristics and outcomes in patients with uveitis caused by herpes simplex virus (HSV) and varicella zoster virus (VZV).


METHODS
Retrospective comparative study.


METHODS
Forty patients with HSV uveitis and 24 patients with VZV uveitis.


METHODS
A retrospective study of 40 patients with HSV and 24 patients with VZV uveitis was performed. The patients were followed between May 1987 and September 1999 (median follow-up time, 46 months). The diagnosis of HSV uveitis was made clinically and serologically, and the diagnosis of VZV uveitis was made clinically.


METHODS
Clinical presentation of the disease, ocular complications, visual acuity, surgical and medical treatments needed.


RESULTS
Both populations were comparable for gender and age at disease onset. The course of the disease tended to be remitting and recurrent in HSV patients and chronic in VZV patients (P = 0.046). The most frequent ocular complication in both groups was secondary glaucoma (54% HSV, 38% VZV). Twenty-five percent of VZV patients developed posterior pole complications (cystoid macular edema, epiretinal membrane, papillitis, retinal fibrosis, and detachment) compared with 8% of HSV patients (P = 0.069). Treatment modalities selected were generally similar in the two groups, although periocular and systemic steroids were required more frequently in HSV patients (60% versus 25%; P = 0.01). Surgical procedures were required with similar frequency in both populations. The percentage of eyes that were legally blind at end of follow-up was also comparable (HSV, 20%; VZV, 21%). The visual outcome was similar in the studied populations.


CONCLUSIONS
This study represents the only direct comparison of HSV and VZV uveitis patients reported in the literature. HSV patients were more likely to be treated with periocular and systemic steroids, and VZV patients were more likely to develop posterior pole complications (a finding of borderline significance). Other parameters evaluated in this study were not statistically different in the two patient groups.
Miserocchi
Elisabetta
E
Immunology and Uveitis Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston 02114, USA.
Waheed
Nadia K
NK
Dios
Enrique
E
Christen
William
W
Merayo
Jesus
J
Roque
Manolette
M
Foster
C Stephen
CS
D000212:Acyclovir / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D002386:Cataract / Q000209:etiology; D005260:Female; D005901:Glaucoma / Q000209:etiology; D005938:Glucocorticoids / Q000627:therapeutic use; D006563:Herpes Zoster Ophthalmicus / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006566:Herpesviridae Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D012008:Recurrence; D012164:Retinal Diseases / Q000209:etiology; D012189:Retrospective Studies; D014605:Uveitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D014792:Visual Acuity / Q000502:physiology*
D000998:Antiviral Agents; D005938:Glucocorticoids; D000212:Acyclovir