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Juan Carlos Serna-Ojeda, Arturo J Ramirez-Miranda, Alejandro Navas, Aida Jimenez-Corona, Enrique O Graue; Herpes simplex virus disease of the anterior segment in children. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5757.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze the clinical presentation, characteristics, treatment with topic and oral acyclovir, recurrences and final outcomes and complications of patients aged 17 or younger with herpes simplex virus disease of the anterior segment.
An observational and retrospective study was performed with review of the medical records of all the children with diagnosis of herpes simplex infection of the anterior segment at an ophthalmologic reference center in Mexico City, from 2002 to 2012. Patients were diagnosed based in history and examination, and in specific cases with viral culture and polymerase chain reaction test. Patients were treated with topical or oral acyclovir according to the clinical presentation. Recurrent disease was analyzed with Kaplan-Meier curves. Main outcome measures included: final visual acuity, bilaterality, recurrent disease and surgical procedures performed.
One hundred and three patients were included with a median age at presentation of 9 years, from which 6 had a bilateral and simultaneous disease. The median follow up time was 18 months (range 18 days - 12 years). The most common clinical manifestation was epithelial dendritic keratitis in 42 eyes (38.5%) with 15 patients presenting multiple forms of herpes simplex virus disease. Recurrent disease was evident in 42 (38.5%) of the eyes. Eight patients underwent a penetrating keratoplasty at a median age of 15 years. The median final visual acuity in the group of patients was 20/40.
In this paper, one of the largest series of pediatric population with herpes simplex virus of the anterior segment, we conclude that these patients have a high rate of epithelial dendritic manifestation and recurrent disease.
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