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Herpes simplex versus herpes zoster keratitis: comparison of disease, treatment, prophylaxis and recurrence in the Surrey and Sussex region of the UK

Session Details

Session Title: Cornea Medical

Session Date/Time: Monday 07/10/2013 | 08:00-10:00

Paper Time: 08:00

Venue: Elicium 1 (First Floor)

First Author: : H.Ali UK

Co Author(s): :    M. Nanavaty              

Abstract Details

Purpose:

To study the clinical course and compare the prophylaxis and recurrence in patients with herpes simplex keratitis (HSK) versus herpes zoster keratitis (HZK) in the Surrey & Sussex region of the UK.

Setting:

Department of Ophthalmology, East Surrey Hospital, Surrey & Sussex NHS Trust, Redhill, United Kingdom

Methods:

This is a retrospective review of clinical electronic notes of 149 patients presenting with HSK or HZK requiring at least one follow-up appointment between January 2006 and August 2012 in the Surrey and Sussex region of the UK. Data on demographics, anterior segment complications, treatment, surgical procedures, prophylaxis and recurrences were documented for each follow-up appointment.

Results:

A total of 150 eyes (147 patients, 108 with HSK and 42 with HZK) were included. All patients had adequate treatment at presentation with their first episode. Prophylaxis with antivirals was greater for HSK (P=0.00). Prophylaxis with oral Aciclovir alone was greater for HSK (P<0.01) whereas topical steroid only prophylaxis was greater for HZK (P=0.00). Flare-ups were greater with HSK (P=0.04), however flare-ups whilst on prophylaxis were equal between the HSK and HZK groups (54% and 47% respectively, P>0.05). In very few patients with recurrences, some inconsistency in prophylaxis titration were noted. Whilst majority of the patients were on adequate prophylactic regime with good compliance, recurrences were still noted. Epithelial flare ups were the commonest type of recurrence irrespective of the primary lesion (epithelial, endothelial or combination) in HSK and HZK groups.

Conclusions:

There are variations in treatment and prophylaxis practice patterns for HSK and HZK amongst clinicians. Compared to HZK, HSK results in more recurrences despite Aciclovir prophylaxis with good patient compliance. Further studies are needed to establish the resistance patterns and dosing of Aciclovir as a prophylaxis and for the introduction of stronger prophylactic antivirals in the National Health Service.

Financial Interest:

NONE