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Petja I. Vassileva, Gueorgui T. Markov; Hypertensive Herpetic Uveitis - Diagnostic And Therapeutic Approach: A Case Series. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2790.
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To share our experience in the diagnosis and treatment of patients with ocular hypertension and secondary glaucoma as a result of herpetic uveitis
Retrospective study on 51 consecutive patients, treated for herpetic uveitis for the period from May 2010 to November 2011. Follow-up period varied from 6 to 18 months. Diagnosis was based on medical history, clinical ophthalmologic exam, and specialized laboratory investigations. All patients received antiglaucomatous therapy, antiviral medications, anti-inflammatory drugs, and treatment for other complications of the herpetic infection
In 13 (25.49%) out of 51 patients, we diagnosed raised IOP. Infection with VZV was found in 10 (76.9%) of that patients, and with HSV - in 3 (23.07%). We observed keratouveitis in 8 (61.54%) of the cases, and iridocyclitis - in 5 (38.46%). In 7 (53.84%) patients we diagnosed ocular hypertension, in 4 patients with the initial manifestation of uveitis, and in 3 - in recurrent uveitis. IOP measured as high as 60.0 mmHg in some of the cases. As a result of treatment, the IOP values fell within normal limits in about 2 months. Secondary glaucoma, requiring long-term antiglaucomatous therapy, was diagnosed in 6 (46.15%) cases. In that group, we also succeeded in achieving satisfactory control of IOP with appropriate treatment.
Ocular hypertension is a common and typical complication of anterior herpetic uveitis, often pathognomonic for the diagnosis. It occurs more frequently in the acute stage of the inflammatory process and, therefore, can successfully be treated. Secondary glaucoma is usually observed in chronic or recurrent cases, associated with advanced morphologic alterations in the anterior segment of the eye. Treatment with antiviral, antiglaucomatous, and anti-inflammatory medications has a beneficial effect on the evolution and prognosis of ocular hypertension
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