Prevention of Herpes and Zoster keratitis

• Published in: Acta ophthalmologica (Oxford, England) Vol. 94; no. S256
• Main Authors: Labetoulle, M., Rousseau, A.
• Format: Journal Article
• Language: English
• Published: Malden Wiley Subscription Services, Inc 01.10.2016
• Subjects: Antiviral agents; Complications; Cornea; Exanthema; Ganglia; Herpes simplex; Herpes zoster; Herpes zoster ophthalmicus; Immunosuppression; Immunosuppressive agents; Keratitis; Nervous system; Ophthalmology; Risk factors; Steroid hormones; Steroids; Surgery; Trigeminal ganglion; Varicella; Viruses
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1755-3768.2016.0050

Summary Herpes Simplex Virus (HSV) and Varicella‐zoster Virus (VZV) are two leading causes of sight‐threatening keratitis. They are able to become latent in nervous system, especially the trigeminal ganglia in which they can reactivate, thus producing new viral particles that finally reach the cornea. Episodes of HSV keratitis may occur spontaneously or following a triggering factor like immunosuppression (including topical steroids), topical inflammation and nerve injuries. Ocular surgery, which combines several of these factors, is a strong risk factor of HSV keratitis reccurence. In case of exposure to one of these triggering factors, prevention with oral antiviral drugs reduces the risk of relapse of HSV keratitis. For VZV, the main risk factor of keratitis is the occurrence of chickenpox or herpes zoster ophthalmicus (HZO) some days to weeks before. The prescription of oral antiviral drugs at the time of cutaneous rash is efficient for reducing the risk of ocular complications of HZO. However, the arrival of the anti‐HZO vaccine could change the deal in the next years.