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[The latest in herpes simplex keratitis therapy].
1Service 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
Journal Francais D'Ophtalmologie
|June 5, 2004
Summary
Long-term oral acyclovir significantly reduces herpetic keratitis recurrences, a chronic eye disease. This antiviral therapy offers a promising strategy for preventing vision loss from frequent or severe relapses.
Area of Science:
- Ophthalmology
- Virology
- Immunology
Context:
- Herpetic keratitis presents with recurrent episodes and poses a risk of vision loss, particularly with frequent and severe relapses.
- Two main clinical forms, epithelial and stromal keratitis, exhibit different progression rates and treatment responses, even with combined antiviral and steroid therapy.
Purpose:
- To review advancements in herpetic keratitis therapy over the past two decades.
- To highlight the efficacy of long-term oral acyclovir in preventing recurrent ocular herpes events.
- To discuss the role of antiviral prophylaxis in high-risk periods and identify areas for future research.
Summary:
- Herpetic keratitis is increasingly managed as a chronic condition, with randomized controlled trials confirming that long-term oral acyclovir decreases spontaneous ocular events.
- Preventive antiviral treatment is effective during high-risk periods, such as ocular surgery, for patients with a history of herpetic keratitis.
- Optimal duration and dosage for antiviral prophylaxis remain undefined, and future strategies like vaccination may reduce the need for corneal grafts.
Impact:
- Established long-term oral acyclovir as a key therapy for reducing herpetic keratitis recurrences and preventing vision loss.
- Provides evidence for the use of antiviral prophylaxis in specific high-risk scenarios.
- Identifies knowledge gaps and future research directions, including optimizing antiviral strategies and exploring novel preventative measures like vaccination.