Herpetic Eye Disease Study

Barron, Bruce; Gee, Lauren; Hauck, Walter W.; Kurinij, Natalie; Dawson, Chandler R.; Jones, Dan B.; Wilhelmus, Kirk R.; Kaufman, Herbert E.; Sugar, Joel; Hyndiuk, Robert A.; Laibson, Peter R.; Stulting, R. Doyle; Asbell, Penny A.; Margolis, Todd P.; Nozik, Robert A.; Ostler, H. Bruce; Insler, Michael S.; Matoba, Alice Y.; Waring, George O.; Wilson, Louis A.; Koenig, Steven B.; Massaro, Bruce M.; Davis, Andrew Powers; Newton, Michael; Lam, Sheridan; Robin, Jeffrey B.; Tessler, Howard H.; Cohen, Elisabeth J.; Leavitt, Kent G.; Rapuano, Christopher J.; Hidayat, Jon E.; Bangdiwala, Shrikant I.; Barlow, William E.; Chandler, John W.; Nelson, Lawrence J.; Nesburn, Anthony B.; Merin, Lawrence M.; Todaro, L

doi:10.1016/s0161-6420(13)31155-5

Cited by 189 publications

(48 citation statements)

References 37 publications

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“…1 A previous episode of stromal keratitis significantly increases the probability of subsequent episodes. The Herpetic Eye Disease Study group (HEDS) 8 found that patients who report a previous episode of stromal keratitis are 10 times more likely to experience a recurrence. In addition, the closer the attacks, the greater the likelihood of future episodes.…”

Section: Discussionmentioning

confidence: 99%

“…When the disciform keratitis is overlying the visual axis, topical steroids such as Pred Forte (prednisolone acetate 1%) are indicated. The HEDS study 8,10 demonstrated that patients with stromal keratitis with-out an accompanying epithelial keratitis improve more rapidly when treated with topical steroids along with a topical antiviral agent (such as trifluridine). For prophylactic anti-viral treatment, trifluridine should be administered at least four times a day.…”

Section: Discussionmentioning

confidence: 99%

“…Disciform keratitis can leave a significant scar, depending on its severity and any delay in initiating treatment, but the use of steroids minimises the damage. 4,7,8 Oral anti-virals can be used in the treatment of HSV infections. Sozen, Ayundak and Akyol 12 claimed that oral valacyclovir is equivalent in efficacy in treating HSV keratitis to topical acyclovir ointment (3%).…”

Section: Discussionmentioning

confidence: 99%

“…Sozen, Ayundak and Akyol 12 claimed that oral valacyclovir is equivalent in efficacy in treating HSV keratitis to topical acyclovir ointment (3%). The HEDS group 8 found that the use of oral acyclovir provided no additional benefit to topical steroids and a topical anti-viral (trifluridine) in the treatment of HSV stromal keratitis. Oral acyclovir did not appear to prevent the development of stromal keratitis or iritis in those patients with HSV keratitis being treated with trifluridine.…”

Section: Discussionmentioning

confidence: 99%

“…Oral acyclovir did not appear to prevent the development of stromal keratitis or iritis in those patients with HSV keratitis being treated with trifluridine. The HEDS group 8 claimed that oral acyclovir 400 mg twice a day decreased the recurrence rate of any type of HSV disease, though when the patients came off the medication, the rate increased to that of the untreated group. Oral acyclovir may also play a role in the treatment of HSV iridocyclitis, when used in combination with topical steroids and topical anti-virals.…”

Section: Discussionmentioning

confidence: 99%

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Is herpes simplex virus keratitis a different disease in children?

Lonsberry

2008

Clinical and Experimental Optometry

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Ocular infections resulting from herpes simplex viral infection can result in significant ocular morbidity. Crucial in preventing this complication is the need for appropriate diagnosis and initiation of treatment. In addition, most of the studies on herpes simplex viral infections involve adult populations. It is important to consider that children have a different progression of the disease process and may require an altered treatment regimen.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Is herpes simplex virus keratitis a different disease in children?

Lonsberry

2008

Clinical and Experimental Optometry

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Prevention of Herpes Simplex Virus Eye Disease

Lairson

Begley²,

Reynolds³

et al. 2003

Arch Ophthalmol

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To estimate the cost of treating herpes simplex virus (HSV) eye disease, and to evaluate the incremental cost-effectiveness of chronic suppressive antiviral prophylaxis for reducing ocular HSV recurrences. Methods: An economic decision-tree model was used on follow-up data from 703 patients with prior ocular HSV disease who were enrolled in a Herpetic Eye Disease Study multicenter clinical trial that evaluated the prolonged use of oral acyclovir. Costs were based on wholesale drug prices, Medicare fees, and national health surveys. Incremental cost-effectiveness ratios for all patients and for patients with prior stromal keratitis were calculated as the additional net cost of acyclovir prophylaxis compared with the number of cases of ocular herpes prevented during 12 months. One-and 2-way sensitivity analyses evaluated the effect of different treatment costs and recurrence risks. Results: Approximately $17.7 million is expended annually to treat the estimated 59000 new and recurrent episodes of HSV eye disease occurring among 29000 individuals each year in the United States. Chronic suppressive oral acyclovir costs $8532 per ocular HSV episode averted. The incremental cost per infection averted would decline by up to 51% if antiviral prophylaxis were more effective and by up to 87% if patients had a higher recurrence risk. Targeting prophylaxis to patients with a history of stromal keratitis is not more cost-effective than providing oral acyclovir for patients with any prior HSV eye disease. Conclusions: Herpetic eye disease is costly to treat and prevent. Because prophylactic oral acyclovir is not a costeffective option for all patients with previous HSV eye disease, therapeutic decisions must be made on a caseby-case basis.

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