[The latest in herpes simplex keratitis therapy].
Herpetic keratitis is characterized by spontaneous recurrences and a risk of vision loss, the latter being more serious when relapses are frequent and severe. Two clinical forms are commonly distinguished: epithelial keratitis, usually quickly resolved with topical antivirals, and stromal keratitis, which has a slower progression, even when both steroids and antivirals are used. Great strides have been made during the last 20 Years in the therapy of herpes keratitis, which is now considered and treated as a chronic disease. Randomized controlled studies definitively showed the decrease in spontaneous herpetic ocular events in patients treated with long-term oral acyclovir. The effectiveness of preventive treatment has also been shown during high-risk periods, especially ocular surgery, in patients with a history of herpes keratitis. However, the optimal duration and dosage of antiviral prevention have yet to be defined. We can also hope that in the future novel antiviral strategies such as vaccination will reduce the place of herpes keratitis as an indication for corneal graft.
Labetoulle
M
M
Service d'Ophtalmologie, Centre Hospitalier Universitaire de Bicêtre, Assistance Publique-Hôpitaux de Paris, Laboratoire de Virologie moléculaire et structurale, CNRS, Gif sur Yvette. marc.labetoulle@bct.ap-hop-paris.fr
D000212:Acyclovir / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D007065:Idoxuridine / Q000627:therapeutic use; D016849:Keratitis, Herpetic / Q000188:drug therapy* / Q000453:epidemiology; D014271:Trifluridine / Q000627:therapeutic use
D000998:Antiviral Agents; D007065:Idoxuridine; D015774:Ganciclovir; D014271:Trifluridine; D000212:Acyclovir