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Rosalynn Siantar, Rachel Lim, ELIZABETH WONG, SU LING HO, STEPHEN TEOH, Rupesh Vijay Agrawal; Analysis and outcome of 80 cases of herpetic anterior uveitis at a tertiary referral eye care centre in Singapore. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4132.
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© ARVO (1962-2015); The Authors (2016-present)
Herpetic uveitis is a common cause of anterior uveitis (AU) and have sight-threatening complications. We investigated the epidemiology, clinical features and treatment outcome of herpetic AU in an Asian population.
This is a retrospective observational study of Asians from 2005-2014 at a Singapore tertiary referral eye centre. Patients with clinically diagnosed herpes simplex (HSV) and varicella zoster virus (VZV) AU were included. The data collected were age, gender, race, presenting and follow-up visual acuity (VA), presenting symptoms and signs, anterior chamber (AC) tap results, treatment regime and recurrences if any. Qualitative variables were expressed as percentages. Quantitative variables were expressed as mean values ± standard deviation if they followed a normal distribution or as median values (range) if not. Data was analyzed using Stata SE v13.0 (Stata Corp, College Station, TX, USA).
80 patients were included in the analysis. The mean age was 56.8±16.3(11-93) years. There was no predilection for gender and most patients were Chinese(73.7%). 97.5% had unilateral disease. The average follow-up period was 196.33±192.98 (1-988) weeks. The commonest symptoms were eye redness, pain and blurring of vision. Mean presenting VA (Snellen logMAR) was 0.39 and improved by last follow-up to 0.21 (p<0.001). The commonest signs were AC inflammation in all patients (SUN classification), followed by keratic precipitates (82.5%) and stromal oedema (33.75%). 56.2% of patients had AC cells 2+ and more. 30 cases were HSV and 50 were VZV related. 27.5% of patients had an AC tap. 7.5% was HSV-positive and 1.25% was VZV-positive. Complications included raised intraocular pressure (31.25%) and corneal scarring (26.25%). 91.3% patients had oral acyclovir, 65.8% had acyclovir ointment and 11.2% had oral prednisolone with significant heterogeneity in duration of treatment. For 66(82.5%) patients with minimum follow up of 12 weeks, 35(53%) patients had complete resolution while 47 % had at least 1 recurrence. Of these, 9.1% developed chronic uveitis and never resolved.
In our study population, herpetic AU patients commonly present with eye redness and AC inflammation. We found significant heterogeneity in treatment regime. Though there was significant recovery in vision, almost half the patients had recurrence warranting prolonged therapy with oral acyclovir.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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