Clinical and Therapeutic Aspects of Viral Ocular Pathology in Brazzaville

Abstract

Introduction: Viruses can act in two ways, either by a direct pathogenic effect, or indirectly by inducing immunosuppression and favoring the action of other so-called opportunistic viruses. This survey had a double objective, describe the clinical aspects of viral ocular pathology and state its principles of treatment. Materials and Methods: Descriptive cross-sectional study carried out over 2 years at the Ophthalmology department of the University Hospital of Brazzaville. Patients 18 years of age or older with viral ocular pathology were included. The diagnosis was made on the sole basis of anamnestic and / or clinical arguments. None of the viruses involved had been directly detected, with the exception of HIV. Biologically proven patients with a coinfection (bacteria, parasite, fungus) were excluded. HIV serology had been systematic. Four parameters were analyzed: type of virus, structures affected, pathologies diagnosed, anti viral treatments used. Results: Two hundred twenty-five (225) patients were included. The mean age was 44 ± 2.1 years. Sex ratio was 0.8. Viruses: Adenovirus (51.1%), Herpes zoster (19.5%), HIV (18.7%), Herpes simplex (7.5%), CMV (3.2%). Main structures affected: eyelid (86.2%), chorioretin (6.4%). Main pathologies: Adenovirus conjunctivitis (61.1%), shingles (16%), primary herpes simplex infection (8%) Keratitis (6.4%), chorioretinitis (6.4%), uveitis (2.1%). Anti viral treatments used: Valaciclovir, Ganciclovir and anti retroviral. Conclusion: Viral ocular pathology is dominated by Adenovirus conjunctivitis and infections due to 3 types of herpes viridae (Herpes zoster, Herpes simplex and CMV). These herpes viridae are generally responsible for opportunistic diseases following immunosuppression linked to HIV.