Original Article

Clinical Diagnosis and Treatment to Patients with Herpetic Anterior Uveitis

  • Sibel Aksoy
  • Yonca Aydın Akova

Received Date: 21.07.2009 Accepted Date: 03.09.2009 Turk J Ophthalmol 2009;39(6):485-490

Purpose:

To emphasize the importance of clinical findings in herpetic anterior uveitis and to evaluate treatment modalities.

Methods:

Files of the 45 patients, who were followed in our clinic due to herpetic anterior uveitis between 1998-2008 were retrospectively reviewed. The diagnosis was made according to clinical findings including; active or inactive keratitis, prior or recent herpetic dermatitis. In cases without clear evidence of recent or preexisting herpetic dermatitis or keratitis; diagnosis was made according to the presence of medium-sized keratic precipitates in a localized or diffuse pattern, iris atrophy, and elevated intraocular pressure.

Results:

There were 24 female and 21 male patients with the mean age of 53.4±17.9 (11- 81) years and with the mean follow-up of 30 (12-114) months. While 35 of the patients had HSV uveitis, 10 patients had VZV uveitis. All of the patients had inflammation in the anterior chamber, 26 patients had keratitis (active or inactive), 20 patients had localized iris atrophy, intraocular pressure was elevated in 24 patients and 10 patients had posterior synechiae. All patients treated with topical steroid and oral antiviral agents. Topical antiviral therapy were given to the 26 patients and oral steroid therapy were given to the 15 patients. Visual acuity increased to a mean of 2.8 line according to the Snellen chart. In two patients, trabeculectomy have been performed because of uncontrolled glaucoma, despite maximum antiglaucomatous therapy. Recurrences occured in 20 patients.

Conclusion:

The diagnosis of herpetic anterior uveitis can be made clinically. Despite recurrent inflammation may involve in all of the anterior segment structures; complications and recurrences can be decreased with correct diagnosis and prompt therapy.

Keywords: Herpetic uveitis, herpes simplex, herpes zoster, acyclovir

Full Text (Turkish)