Viral keratitis. Diagnosis and treatment

Abstract

Introduction: Herpes Simplex Virus (HSV) is a human virus spread worldwide. Today more than 90% of adults carry systemic antibodiesto HSV-1. Herpetic keratitis is the most common form of the HSV eye disease, counting for 50% to 90% of ocular herpes. This is the leading cause of comeal blindness among developed countries and the most common indications for comeal transplant. Purpose and objectives: To determine the diagnostic features and treatment outcomes for herpetic keratitis. Materials and methods: all records of the pacients diagnosted with herpetic keratitis from 2007 through 2013 at the Ophtalmological Department of Medical Centre “OVISUS" Chisinau, were retrospectively reviewed. Results: The study revealed 30 pacients diagnosted with herpetic keratitis from 2007 to 2013. The study grup was consisted of 21 female (70% ) with mean age 59,67±18,16 and 9 male (30%) with mean age 50,56±16,71. Evaluating the pacients by age groups it is noticed an rising trend through young adults age 20-30, and another peak among elders age 71-80. Also pacients showed comorbidities: hypertension-36,67%, diabetes-20% , diseases that affect immune system like viral respiratory infection-10%, HBV-10%, HCV-3,33% . The study group showed other ocular diseases: glaucom -16.67%, cataract-10%, artifakia-6,67% , myopia-6,67% , retinal degeneration-3,33%, macular dystrophy-3,33% ,blefaritis-3,33%, pterygium -3,33%. The most common complains recorded were: decreased visual acuity-93,33% , tearing-83,33%, photophobia-70% , ocular pain, conjunctival injection-66,67%, blepharospasm -33,33%. Ocular examination revealed the following manifestations of keratitis: herpetic epithelial keratitis-20% , herpetic stomal keratitis-20% , herpetic keratouveitis-33,33% , herpetic corneal ulcer-26,67%. Surgical treatment was performed on 30% of pacients with an increase of visual acuity for 33,33% of pacients. Overall 70% of pacients required: antiviral medication, topical antibiotics, immunomodulatory drugs, topical steroids and also showed a significantly greater improvement in visual acuity for 33,33% pacients. Conclusion: Current data suggest that herpetic keratitis affects more women than men, pacinets with decreased immunity, and both surgical treatment and medication therapy have a better outcome with an increased visual acuity.