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Herpes and zoster keratitis
Author(s) -
LABETOULLE M
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.1642.x
Subject(s) - keratitis , herpes zoster ophthalmicus , medicine , cornea , dermatology , varicella zoster virus , chickenpox , herpes simplex virus , immunology , disease , virus , virology , herpesviridae , ophthalmology , viral disease , pathology
The two leading causes of viral infection of the cornea with potential severely impaired visual acuity are the Herpes Simplex Virus (HSV) and the Varicella‐zoster Virus (VZV). Both of them are able to become latent in the trigeminal ganglia, before reactivation and migration along the trigeminal fibers innervating the cornea. The clinical settings of keratitis may vary from an epithelial defect (dendritic of geographic) to a more severe disease involving the stroma and/or the endothelium. Most of first episodes of HSV keratitis occur from the second to the fifth decade of life, and associated skin lesions are not frequent. In contrast, VZV keratitis mostly occurs after the sixth decade, as an associated finding of herpes zoster ophthalmicus (HZO). However, recent studies have highlighted the possibility of HSV keratitis in elderly, while other studies reported VZV keratitis in children, either isolated or associated with HZO. The curative options for treatment of HSV keratitis are now well established, but the preventive regimens of antiviral drugs still have to be optimized, since the most popular treatment, based on the results of the HEDS study, only reduces the rate of relapses in a two‐fold manner. For VZV, vaccines against chickenpox and HZO may significantly change the epidemiologic data when they will be more frequently used in European countries.