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Herpes Simplex Virus Disease of the Anterior Segment in Children

Juan Carlos Serna-Ojeda1, Arturo Ramirez-Miranda, Alejandro Navas

  • 1Departments of *Cornea and Refractive Surgery and †Ocular Epidemiology, Instituto de Oftalmologia "Conde de Valenciana," Mexico City, Mexico.

Cornea
|August 13, 2015
PubMed

Insights

Herpes simplex virus (HSV) disease in children often presents as epithelial dendritic or interstitial keratitis. This condition has a high recurrence rate, impacting pediatric eye health.

Area of Science:

  • Ophthalmology
  • Virology
  • Pediatrics

Background:

  • Herpes simplex virus (HSV) is a common cause of infectious eye disease.
  • Anterior segment HSV disease in pediatric patients requires specific clinical understanding.
  • Limited data exists on the long-term outcomes and recurrence patterns in young individuals.

Purpose of the Study:

  • To analyze the clinical presentation of anterior segment herpes simplex virus (HSV) disease in patients 17 years or younger.
  • To characterize treatment, recurrences, and final outcomes, including complications.
  • To understand the epidemiology of HSV eye infections in a pediatric cohort.

Main Methods:

  • Retrospective observational study of 103 pediatric patients diagnosed with anterior segment HSV infection (2002-2012).
  • Diagnosis confirmed via clinical history, examination, and in select cases, viral culture and PCR.
  • Analysis of final visual acuity, bilateral involvement, and recurrence rates using Kaplan-Meier curves.

Main Results:

  • Median age at presentation was 9 years; 6 patients had bilateral, simultaneous disease.
  • Most common manifestations included epithelial dendritic keratitis (38.5%) and interstitial keratitis (35.7%).
  • Median final visual acuity was 20/40, with a high recurrence rate of 38.5% at a median of 15 months.

Conclusions:

  • Epithelial dendritic and interstitial keratitis are the predominant forms of anterior segment HSV disease in children.
  • The pediatric population experiences a significant rate of recurrent HSV eye infections.
  • Early diagnosis and management are crucial for improving visual outcomes in pediatric HSV keratitis.
Abstract

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