Clinical characteristics and factors affecting visual outcomes in patients with herpes simplex keratitis: A tertiary...

Herpes Simplex Keratitis (HSK) is a leading cause of infectious corneal blindness globally. However, clinical data and visual outcomes specific to the Malaysian population are limited. This study aimed to identify common clinical features, visual outcome and its associated factors in patients treated at a Malaysian tertiary hospital.

A retrospective cohort study was conducted at Hospital Pakar Universiti Sains Malaysia (HPUSM) between June 2013 and June 2024. Medical records of patients diagnosed with HSK and followed for at least six months were reviewed. Sixty-seven patients were included. Data collected included demographics, presenting symptoms, best-corrected visual acuity (BCVA) at presentation and after treatment, ocular findings, subtype of HSK and complications. Statistical analyses were performed using SPSS version 28.0. Paired t-tests was used to analyse changes in BCVA and multiple linear regression was performed to identify factors associated with final visual outcome.

The mean age at presentation was 50.42±17.19 years with a slight male predominance (52.2%). Most cases were unilateral (91.1%). Common presenting symptoms were reduced vision (89.6%) and eye redness (85.1%). Keratouveitis was the most frequent subtype (37.3%). Complications included corneal scarring (73.1%), recurrence (49.3%) and glaucoma (11.9%). BCVA significantly improved post-treatment (p<0.001). Older age, central corneal involvement, elevated intraocular pressure at presentation, and stromal vascularisation were significantly associated with poorer visual outcomes.

This study outlines the clinical spectrum and visual outcomes of HSK at a tertiary hospital in Malaysia and identifying several predictive factors for poor vision. These findings may aid clinicians in risk stratification and optimising management strategies.