RETROSPECTIVE STUDY OF 111 PATIENTS WITH HERPETIC ANTERIOR UVEITIS

Abstract

RF1-4RETROSPECTIVE STUDY OF 111 PATIENTS WITH HERPETICANTERIOR UVEITISOtuk Berna M. (Istanbul University Istanbul Faculty of Medicine,Ophthalmology Department) Altinkurt Emre (Istanbul UniversityIstanbul Faculty of Medicine, Ophthalmology Department), Tugal-Tutkun Ilknur (Istanbul University Istanbul Faculty of Medicine,Ophthalmology Department)Introduction and objectives: To describe the clinical features andoutcomes in patients with herpetic anterior uveitisMethods: A retrospective study of 111 patients with herpetic anterioruveitis diagnosed cl inically at the Dep artment ofOphthalmology, Istanbul Faculty of Medicine, from January 1996to December 2006. When present, herpetic corneal disease andactive or past episode of herpes zoster ophthalmicus were considereddiagnostic of herpetic anterior uveitis. In patients withoutcorneal involvement, the diagnosis was based on the presence of atleast three of the following features: recurrent unilateral attacks inthe same eye, granulomatous keratic precipitates, patchy or sectoraliris atrophy and/or transillumination defects, distorted pupil, andacute elevation of intraocular pre s s u re during infl a m m at o ryepisodes.Results: Fifty patients were male, 61 were female. Mean age atonset of uveitis was 39.2 (5-74) years. Three atopic patients hadbilateral involvement. Twelve patients had active or a past episodeof herpes zoster ophthalmicus. Ocular findings were granulamatousanterior uveitis (96.3%), active keratitis or corneal scars (57%), elevatedintraocular pressure (50.8%), iris atrophy and/or translumminationdefect (48.2%), distorted pupil (25.4%), and posteriorsynechiae (26.3%). The recurrence rate was 0.45 / person year. In49 eyes (43%) there was no corneal scar or active keratitis duringfollow-up period. Topical corticosteroid and oral antiviral therapywere administered to all patients during active episodes. Oral corticosteroidtherapy was administered to 21.6% of the patients. Finalvisual acuity was worse than 0.5 in 16.6% of the involved eyes andwas due to corneal scarring and cataract formation. The patientswith only iridocyclitis had no permanent visual loss. No patient hadany posterior pole complication. Two patients had secondary glaucoma.Conclusions: Herpetic anterior uveitis is a distinct entity that canbe diagnosed clinically. Although the recurrence rate is high, visualoutcome is favorable in most cases.Financial fundings: (None.)