Ocular herpes simplex infection: pathogenesis and current therapy.

Area of Science:

• Ophthalmology
• Virology
• Immunology

Background:

• Ocular herpes simplex disease exhibits diverse clinical presentations and recurrences.
• Pathophysiology involves viral-host interactions, immunologic events, tissue damage, and antiviral drug toxicity.
• Recent research elucidates the herpes simplex virus (HSV) genome's role in disease virulence.

Purpose of the Study:

• To present a clinical model and hypothesis for ocular HSV pathophysiology.
• To propose a classification system for ocular herpes simplex based on disease manifestations and host response.
• To outline a management plan for ocular HSV informed by disease process knowledge.

Main Methods:

• Literature review and synthesis of laboratory and clinical research findings.
• Development of a working hypothesis on complex pathophysiologic features.
• Analysis of viral genome studies concerning virulence and pathogenicity.

Main Results:

• Established a clinical model for ocular HSV.
• Defined the viral genome's contribution to pathogenicity.
• Proposed a classification system integrating viral disease and host response.
• Identified key factors for medical and surgical management strategies.

Conclusions:

• Ocular HSV management requires considering epithelial integrity and active viral presence.
• A nuanced understanding of viral and host factors is crucial for effective treatment.
• The proposed classification and management plan offer a framework for clinical practice.