J Korean Ophthalmol Soc.  2024 Jan;65(1):1-8. 10.3341/jkos.2024.65.1.1.

Long-term Follow-up Results after Prophylactic Antiviral Administration in Patients with Herpes Simplex Keratitis

• Kwon LH
• Kim SJ

• KMID: 2550470
• DOI: http://doi.org/10.3341/jkos.2024.65.1.1

Abstract

Purpose
We analyzed the effectiveness of prophylactic oral antivirals in preventing herpes simplex keratitis (HSK) and the clinical manifestations of recurrence.
Methods
A retrospective analysis was conducted on 30 eyes of 30 patients diagnosed with HSK who received prophylactic oral antiviral agents for > 6 months. We analyzed the initial and recurrent clinical features of HSK, the recurrence rate, and the relationship between recurrence and the duration of oral antivirals.
Results
The mean age of the patients was 64.5 ± 14.0 years, and the mean follow-up duration was 72.4 ± 40.3 months. Of the 30 eyes, 21 (70%) experienced HSK recurrence. The initial clinical features of recurrent cases included herpetic epithelial keratitis (14.3%), stromal keratitis (47.6%), and endotheliitis (38.1%). Notably, no significant associations were observed between the initial clinical features of HSK or the duration of oral antivirals and HSK recurrence. However, male patients exhibited a significantly higher recurrence rate. Epithelial keratitis (47.6%) was the most common HSK type observed during recurrence.
Conclusions
A recurrence rate of 70% was observed in patients who received prophylactic oral antiviral treatment for > 6 months. Herpetic epithelial keratitis was the most common clinical phenotype after recurrence. Notably, long-term clinical monitoring could assist in predicting and preventing recurrence.

Keyword

Acyclovir, Herpetic simplex keratitis, Recurrence