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Updated: Jul 7, 2026
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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, TX 77030, USA. kirkw@bcm.tmc.edu
The Cochrane Database of Systematic Reviews
|February 7, 2008
Summary
Topical antiviral agents like acyclovir are effective for herpes simplex virus (HSV) epithelial keratitis. Combining antivirals with debridement or interferon may speed healing for this common eye infection.
Area of Science:
- Ophthalmology
- Virology
- Pharmacology
Background:
- Dendritic epithelial keratitis, often caused by herpes simplex virus (HSV), has been the subject of numerous clinical trials.
- Previous reviews have focused on specific interventions, but 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.
Main Methods:
- A systematic search of multiple databases (CENTRAL, MEDLINE, EMBASE, etc.) was conducted up to September 2007.
- Included were comparative clinical trials assessing healing rates of topical/oral antivirals or debridement for epithelial keratitis.
- Data extraction and quality assessment were performed, comparing healing proportions at 7 and 14 days.
Main Results:
- Ninety-nine trials with 5363 participants were analyzed.
- Topical vidarabine, trifluridine, acyclovir, and ganciclovir showed high healing rates within one week, with no significant differences among them.
- Interferon monotherapy offered a slight benefit, but combination therapy with another antiviral (e.g., trifluridine) was highly effective.
Conclusions:
- Current antiviral agents for HSV epithelial keratitis are effective and comparable.
- Combining nucleoside antivirals with debridement or interferon may accelerate healing.
- Future research should focus on statistically powered trials assessing epithelial healing outcomes and considering lesion characteristics.
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