Evaluation of the Severity of Herpetic Keratitis in the Atopic Patients

Abstract

Abstract: : Background: The Herpetic Keratitis and Atopic Disease Study (HADS) has the purpose to evaluate the severity of herpes simplex virus (HSV) keratitis in patients with atopic disease. The study started March 2003 and will end in March 2004. We are presenting the first 80 patients in the study. Purpose: To compare the number and types of recurrences of herpes simplex virus (HSV) keratitis and bilaterality in patients with and without atopic disease. Methods: Transversal study that included the first 80 patients with HSV keratitis, previously diagnosed in the Cornea Service, Wills Eye Hospital, who presented for a follow–up visit since March of 2003. All patients had to fill out a questionnaire regarding their atopic disease history. The severity of disease in patients with atopy (Group 1) were retrospectively compared to those without atopy (Group 2), including of the type and number of HSV recurrences and bilaterality of disease. Patients had to have at least one year of follow–up in the Department to be included. Results: 5 patients refused to participate, 25 patients were excluded because of short follow–up, immunosupression or doubt in the clinical diagnosis. Fifty–eight eyes of 50 patients were included in the study and divided into 2 groups: Group 1: patients with positive history for atopic disease: Thirty–three patients (17 male, 16 female), mean age of 47.6 years old (± 20.1) Four patients had bilateral disease Mean follow–up time in the Service: 11.3 years (± 9.7) The mean number of recurrences per year of follow–up was: 0.32 (±0.45) Group 2: patients with negative history for atopic disease: Seventeen patients (9 male, 8 female), mean age of 49 years old (± 17.2) Three patients had bilateral disease Mean follow–up time in the Service: 7.2 years (± 8.2) The mean number of recurrences per year of follow–up was: 0.14 (±0.19) The analysis of variance (ANOVA) was used to compare the rate of recurrences per year between groups 1 and 2 (p=0.082). Conclusions:Preliminary results have not shown statistically significant difference of recurrence rates between both groups, however Group 1 tended to have a higher rate of recurrence than Group 2.

Keywords: herpes simplex virus • keratitis • cornea: clinical science