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Ocular herpetic infection in Moroccan children

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First Author: N.Laaribi MOROCCO

Co Author(s):    T. Abdellaoui   K. Reda   A. Oubaaz              

Abstract Details

Purpose:

Ocular Herpes simplex virus infection in children is complicated by difficulty in examination, patients’ resistance to topical medications, and their susceptibility to amblyopia and recurrency. Few case series of ocular herpetic infection among children have been reported. The aim of our work is to report the clinical characteristics, treatment, and outcomes of 22 Moroccan children with ocular herpetic infection. This study was undertaken in order to raise awareness and to improve management of this important eye disease in children.

Setting:

Department of Ophthalmology at Mohammed V Military Teaching Hospital, Rabat, Morocco

Methods:

This is a prospective study carried out between May 2016 and November 2019 in our hospital. Twenty-two patients 16 years of age or younger were diagnosed with HSV keratitis, blepharitis, conjunctivitis, scleritis or episcleritis. The following data were collected: age at disease onset, risk factors, duration of symptoms, diagnoses given before presentation and diagnostic delay, visual acuity, slit-lamp examination findings, corneal sensation, dose and duration of medications used, and disease recurrence. Statistical analysis was performed using IBM SPSS software version 20 (SPSS, Inc., Chicago, IL).

Results:

We collected 22 cases of ocular herpetic infection. The mean follow-up time was 22 months. 59% of the patient developed at least one herpetic recurrence. Fifteen children had herpetic keratitis. These patients had an extended diagnostic delay 15[4;30] vs 2[2;8] (p=0,03), with more corneal scarring 80% vs 0% (p=0,008) and more recurrences 80% vs 0% (p=0,004) than those with blepharoconjunctivitis. Diagnostic delay higher than 5 days led to more corneal scarring 62% vs 22% (p=0,01) and use of corticosteroids 84% vs 33% (p=0,02). This resulted in an increased length of antiviral therapy 54 days vs 20days (p=0,02).

Conclusions:

As shown in our study, children with herpetic keratitis have worse prognosis than those with blepharoconjunctivitis. Recurrence of ocular herpetic infection is more common in children than adults. Extended diagnostic delay lead to more serious lesions and more use of corticosteroids with an increased length of antiviral therapy. Herpes simplex keratitis in children is a potentially serious sight threatening condition. It should be highly suspected in children with keratitis. Education of parents is important. They should be advised about the recurrences and importance of early attendance.

Financial Disclosure:

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