No author has a financial or proprietary interest in any material or method mentioned.

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Even during a quiescent phase of the disease, unilateral and relapsing HSK significantly impairs the QoL of patients to a similar level as most sight-threatening diseases. The decrease of VA has the greatest overall effect, but other factors also significantly affect QoL, such as the frequency of relapses.

BackgroundCorneal hypoesthesia is the landmark of HSV and VZV keratitis and can lead to neurotrophic keratitis. Diffusion tensor imaging (DTI) is a new magnetic resonance imaging (MRI) derived technique, which offers possibilities to study axonal architecture. We aimed at assessing the potential impact of recurrent HSV or VZV-related keratitis on the axonal architecture of trigeminal nerves using DTI.DesignProspective non-interventional study.ParticipantsTwelve patients and 24 controls.MethodsDTI using MRI of the trigeminal fibers and corneal esthesiometry using the Cochet-Bonnet esthesiometer were acquired for patients affected by unilateral and recurrent HSV or VZV-related keratitis (3 months after the last corneal inflammatory event), and control subjects with no history of ocular or neuronal disease affecting the trigeminal pathways.Main Outcome MeasuresFractional anisotropy (FA) and apparent diffusion coefficient (ADC) were compared between the 2 eyes of both patients and controls, and correlated with corneal esthesiometry.ResultsFA was lower in the trigeminal fibers ipsilateral to the affected eye compared to the non-affected side (0.39±0.02 versus 0.46±0.04, P=0.03). This difference was more important than the intra-individual variability observed in controls. Concomitantly, the asymmetry in ADC results was significantly correlated with the loss of corneal sensitivity in the affected eye.ConclusionsCorneal hypoesthesia related to HSV and VZV keratitis is associated with persistent modifications in the architecture and functionality of the trigeminal fibers. These results add further explanation to the pathogenesis of HSV and VZV-induced neurotrophic keratitis, which may occur despite an apparent quiescence of the disease.

Purpose To determine the prevalence of intraocular hypertension (IOH) in 103 patients referred for uveitis in a tertiary care centre. Methods 103 consecutive patients referred to our department for uveitis were included. Files were retrospectively analyzed for age at time of presentation, gender, type of uveitis (as definedy by International Uveitis Study Group) and etiology, time of IOH (primary or secondary to treatment) and filtering surgical procedure associated. IOP was measured using Goldmann aplanation tonometry and IOH was defined as intraocular pressure ≥ 21mmHg. Results Among all patients, 36% of uveitis were related to a concomitant infectious disease (herpetic disease in 20% of cases and herpes‐zoster in 4%). No significant difference on age, gender was found between all 103 cases of uveitis. At least on episode of IOH was found during the acute phase of the disease in 27 patients (26.2%): anterior uveitis represented 74% of patients. Most of hypertensive cases were associated to herpetic disease (37%), than undetermined etiology in 6 patients (22%), toxoplasmosis uveitis in 2 patients (7,4%). Topical steroids and IOH were associated in 2 patients (7,4%). The IOH was controlled by topical hypotensive treatment in 74,1% of patients, and a filtering surgical procedure was found necessary in 7 patients (25,9%). Conclusion This retrospective study confirms that IOH is a major complication of uveitis, especially in those involving the anterior chamber of the eye and/or related to viruses. Most of cases responded rapidly to combined topical steroids / antiglaucomatous therapy.

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Using patients as their own controls, the outcomes of this study indicate that eyes with recurrent HSK with no apparent decrease in visual acuity (0 logMAR) have significantly greater optical aberrations than eyes with no past history of herpetic disease. This outcome may explain some visual complaints of HSK patients, such as a decrease in contrast quality or reduced colour perception, compared with the unaffected contralateral eye despite apparently normal vision in both eyes.