Herpes Simplex Virus Disease of the Anterior Segment in Children.
OBJECTIVE
To analyze the clinical presentation, characteristics, treatment, recurrences, and final outcomes and complications of herpes simplex virus (HSV) disease of the anterior segment in patients aged 17 years or younger.


METHODS
This is an observational and retrospective study with review of the medical records of all the children diagnosed with herpes simplex infection of the anterior segment at an ophthalmologic referral center, from 2002 to 2012. The diagnosis was made on the basis of the history and examination of patients and in specific cases by viral culture and the polymerase chain reaction. Main outcome measurements included final visual acuity, bilateral disease, and recurrence. Recurrent disease was analyzed with Kaplan-Meier curves.


RESULTS
A total of 103 patients were included with a median age at presentation of 9 years. Of them, 6 had bilateral and simultaneous disease. The median follow-up time was 18 months (range, 18 days-12 years). The most common clinical manifestations were epithelial dendritic keratitis in 42 eyes (38.5%) and interstitial keratitis in 39 eyes (35.7%), with 15 patients presenting multiple forms of HSV disease. The median final visual acuity in the group of patients was 20/40. Recurrent disease was evident in 42 (38.5%) of the eyes, with a median recurrence time of 15 months (95% confidence interval, 8.1-26.2 months).


CONCLUSIONS
In this study, epithelial dendritic and interstitial keratitis were the most frequent forms of disease in the pediatric population with HSV of the anterior segment. A high rate of recurrent disease was present.
Departments of *Cornea and Refractive Surgery and †Ocular Epidemiology, Instituto de Oftalmologia "Conde de Valenciana," Mexico City, Mexico.
Juan Carlos
JC
Serna-Ojeda
Arturo
A
Ramirez-Miranda
Alejandro
A
Navas
Aida
A
Jimenez-Corona
Enrique O
EO
Graue-Hernandez
D000212:Acyclovir / Q000627:therapeutic use; D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000869:Anterior Eye Segment / Q000821:virology*; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis; D015828:Eye Infections, Viral / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D005260:Female; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007635:Keratitis, Dendritic / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology; D016849:Keratitis, Herpetic / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D008297:Male; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies
D000998:Antiviral Agents; D004279:DNA, Viral; D000212:Acyclovir