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Asima Bajwa, Sandra Hu-Torres, C. Stephen Foster; Role of Immunomodulatory Therapy for Herpes Simplex Virus Associated Ocular Inflammation. Invest. Ophthalmol. Vis. Sci. 2013;54(15):133.
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To assess the impact of immunomodulators in patients diagnosed with Herpes Simplex virus associated ocular inflammation, uncontrolled with chronic antiviral treatment.
Retrospective case series. Patients with Herpes virus associated ocular inflammation between October 2006 and October 2011 at Massachusetts Eye Research and Surgery Institute in whom inflammation was not controlled with chronic antiviral medication and who have at least a 6 months follow up after the initiation of immunomodulatory therapy (IMT). Patients taking IMT for other ocular inflammatory conditions and those who started IMT at the same time as antivirals were excluded.
Eight patients being treated with antiviral medication and IMT, age 27 to 80 years (mean 46.3). Clinical diagnosis was scleritis in 7 patients, panuveitis, and anterior uveitis in 1 each. Diagnostic methods employed included scleral biopsy in 6, vitreous PCR in 1 and, conjunctival biopsy in 1. All patients underwent antiviral treatment with either Acyclovir, Famvir or Valtrex . IMT was added for suspected autoimmune component. 7 out of 8 patients were on single drug therapy and 1 on combination of 2 drugs. At 6 months follow up after initiation of IMT all 8 were in remission.
Some patients diagnosed with Herpetic ocular inflammation may not fully respond to systemic antiviral medication in spite of freedom from viral replication. The immune response of the body to damaged tissues may require IMT to control inflammation in such patients.
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