University of Belgrade, Faculty of Medicine, Clinic for Eye Disease, Clinical Center of Serbia, Belgrade, Serbia.
Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Curr Opin Ophthalmol. 2018 Jul;29(4):340-346. doi: 10.1097/ICU.0000000000000482.
Ophthalmic herpes simplex virus (HSV) of the anterior segment is responsible for a range of corneal complications such as scarring, thinning, neovascularization, and severe loss of vision. This review provides current guidelines for treating anterior segment disease related to HSV.
We first review findings from the Herpetic Eye Disease Study (HEDS) clinical trials, and then review new topical and antiviral therapies developed since the HEDS studies. The development of vaccines to prevent recurrent episodes of herpetic infection is briefly reviewed. New corneal surgical procedures, developed since HEDS, may put patients at risk for ocular HSV disease: cross-linking and excimer refractive surgery.
HEDS established the standard of HSV ocular therapy and is still valid today. However, newer antivirals may provide easier compliance with improved bioavailability, efficacy, dosage, and tolerability. Further research is needed to prevent latency of HSV, decrease recurrences, and more effectively treat necrotizing keratitis associated with HSV.
眼前段单纯疱疹病毒（HSV）可引起一系列角膜并发症，如瘢痕形成、变薄、新生血管形成和严重视力丧失。本文综述了与 HSV 相关的眼前段疾病的治疗指南。
我们首先回顾了疱疹性眼病研究（HEDS）临床试验的结果，然后综述了自 HEDS 研究以来开发的新的局部和抗病毒治疗方法。简要回顾了预防单纯疱疹病毒反复感染的疫苗开发。自 HEDS 以来，新的角膜外科手术的发展可能使患者面临眼部 HSV 疾病的风险：交联和准分子屈光手术。
HEDS 确立了 HSV 眼部治疗的标准，至今仍然有效。然而，新型抗病毒药物可能具有更好的生物利用度、疗效、剂量和耐受性，从而提高患者的顺应性。需要进一步研究以预防 HSV 潜伏、减少复发，并更有效地治疗与 HSV 相关的坏死性角膜炎。
