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Ex Vivo Organotypic Corneal Model of Acute Epithelial Herpes Simplex Virus Type I Infection
Published on: November 3, 2012
Therapeutic interventions for herpes simplex virus epithelial keratitis
1Baylor College of Medicine, Cullen Eye Institute, Department of Ophthalmology, 6565 Fannin Street, NC-205, Houston, Texas 77030, USA. kirkw@bcm.tmc.edu
The Cochrane Database of Systematic Reviews
|January 27, 2007
Summary
Topical antiviral agents like vidarabine, trifluridine, and acyclovir effectively treat herpes simplex virus (HSV) epithelial keratitis, with similar healing rates. Combining antivirals with debridement or interferon may accelerate healing.
Area of Science:
- Ophthalmology
- Virology
- Pharmacology
Background:
- Dendritic epithelial keratitis is a common ocular condition caused by herpes simplex virus (HSV).
- Numerous clinical trials have investigated acute treatment strategies for HSV epithelial keratitis.
- A comprehensive systematic review of comparative studies was lacking.
Purpose of the Study:
- To systematically review and compare the efficacy of various therapeutic interventions for dendritic or geographic HSV epithelial keratitis.
- To evaluate topical ophthalmic and oral antiviral agents, as well as debridement methods.
Main Methods:
- A systematic search of multiple databases (CENTRAL, MEDLINE, EMBASE, LILACS, etc.) was conducted.
- Included were comparative clinical trials assessing one- or two-week healing rates.
- Data extraction and quality assessment were performed, comparing healing proportions at 7 and 14 days.
Main Results:
- Data from 98 trials involving 5211 participants were analyzed.
- Vidarabine, trifluridine, and acyclovir showed significantly better one-week healing rates than idoxuridine.
- No significant difference was found among vidarabine, trifluridine, and acyclovir; interferon was effective in combination therapy.
Conclusions:
- Currently available antiviral agents for HSV epithelial keratitis are effective and comparable.
- Combining nucleoside antivirals with debridement or interferon may enhance healing speed.
- Future research should focus on adequate statistical power for epithelial healing outcomes and consider lesion characteristics.
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