Pediatric Herpes Simplex Virus Keratitis

Hsiao, Ching-Hsi; Yeung, Ling; Yeh, Lung‐Kun; Kao, Ling-Yu; Tan, Hsin-Yuan; Wang, Nan-Kai; Lin, Ken‐Kuo; David, H. K.

doi:10.1097/ico.0b013e3181839aee

Cited by 29 publications

(31 citation statements)

References 23 publications

(27 reference statements)

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“…Several studies have also reported that IRF-3 has anti-inflammatory properties which may help control immune-mediated pathology (Hua et al, 2002; Suh et al, 2009; Tarassishin et al, 2011a, 2011b). These studies therefore prompted us to investigate in this study whether a dysfunctional immune response was contributing to the observed pathology and mortality.…”

Section: Discussionmentioning

confidence: 99%

Synergistic control of herpes simplex virus pathogenesis by IRF-3, and IRF-7 revealed through non-invasive bioluminescence imaging

et al. 2013

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Interferon regulatory factors IRF-3 and IRF-7 are central to the establishment of the innate antiviral response. This study examines HSV-1 pathogenesis in IRF-3−/−, IRF-7−/− and double-deleted IRF3/7−/− (DKO) mice. Bioluminescence imaging of infection revealed that DKO mice developed visceral infection following corneal inoculation, along with increased viral burdens in all tissues relative to single knockout mice. While all DKO mice synchronously reached endpoint criteria 5 days post infection, the IRF-7−/− mice survived longer, indicating that although IRF-7 is dominant, IRF-3 also plays a role in controlling disease. Higher levels of systemic proinflammatory cytokines were found in IRF7−/− and DKO mice relative to wild-type and IRF-3−/− mice, and IL-6 and G-CSF, indicative of sepsis, were increased in the DKO mice relative to wild-type or single-knockout mice. In addition to controlling viral replication, IRF-3 and −7 therefore play coordinating roles in modulation of inflammation during HSV infection.

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Section: Discussionmentioning

confidence: 99%

Synergistic control of herpes simplex virus pathogenesis by IRF-3, and IRF-7 revealed through non-invasive bioluminescence imaging

et al. 2013

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“…There is a high risk of visual impairment and recurrences, and prolonged systemic treatment may be required. 2 Limbal stem cell deficiency can be primary, as in aniridia, or secondary, such as in chemical injuries or StevensJohnson syndrome. The hallmark is conjunctivalization of the corneal surface, and it may lead to PEDs and scarring.…”

Section: Causesmentioning

confidence: 99%

“…Early recognition and treatment of this group of diseases are critical because the visual consequences of corneal scarring in a child in the amblyogenic age group can be devastating. 1,2 Allergic Eye Diseases Ocular allergy affects up to 40% of the population, including both adults 3 and children, 4 and encompasses a spectrum of disorders. Six main clinical forms have been described: acute allergic conjunctivitis (AAC) seasonal allergic conjunctivitis (SAC) perennial allergic conjunctivitis (PAC) vernal keratoconjunctivitis (VKC) atopic keratoconjunctivitis (AKC) giant papillary conjunctivitis (GPC)…”

Section: Introductionmentioning

confidence: 99%

Managing a child with an external ocular disease

Wong

Nischal

2010

Journal of American Association for Pediatric Ophthalmology and

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“…Oral valacyclovir or famciclovir are acceptable alternatives in older children 121. The pediatric use of topical trifluridine, vidarabine, and acyclovir ointment has also been described 121,123,124. There have been no reports to date on the use of topical ganciclovir specifically in children, although Phase II studies included children ≥2 years of age.…”

Section: Pediatric Usementioning

confidence: 99%

Ganciclovir ophthalmic gel 0.15% for the treatment of acute herpetic keratitis: background, effectiveness, tolerability, safety, and future applications

Chou¹,

Hong²

2014

TCRM

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Eye disease due to herpes simplex virus (HSV) is a leading cause of ocular morbidity and the number one infectious cause of unilateral corneal blindness in the developed parts of the globe. Recurrent keratitis can result in progressive corneal scarring, thinning, and vascularization. Antiviral agents employed against HSV have primarily been nucleoside analogs. Early generation drugs included idoxuridine, iododesoxycytidine, vidarabine, and trifluridine. While effective, they tended to have low bioavailability and measurable local cellular toxicity due to their nonselective mode of action. Acyclovir 0.3% ointment is a more selective agent, and had become a first-line topical drug for acute HSV keratitis in Europe and other places outside of the US. Ganciclovir 0.15% gel is the most recently approved topical treatment for herpes keratitis. Compared to acyclovir 0.3% ointment, ganciclovir 0.15% gel has been shown to be better tolerated and no less effective in several Phase II and III trials. Additionally, topical ganciclovir does not cause adverse systemic side effects and is therapeutic at lower concentrations. Based on safety, efficacy, and tolerability, ganciclovir 0.15% gel should now be considered a front-line topical drug in the treatment of dendritic herpes simplex epithelial keratitis. Topics of future investigation regarding other potential uses for ganciclovir gel may include the prophylaxis of recurrent HSV epithelial keratitis, treatment of other forms of ocular disease caused by herpesviruses and adenovirus, and ganciclovir gel as an adjunct to antitumor therapy.

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Pediatric Herpes Simplex Virus Keratitis

Abstract: Children with HSV keratitis are at risk for recurrent keratitis and amblyopia. Prolonged systemic antiviral prophylaxis may help to prevent such consequences.

Cited by 29 publications

References 23 publications

Synergistic control of herpes simplex virus pathogenesis by IRF-3, and IRF-7 revealed through non-invasive bioluminescence imaging

Synergistic control of herpes simplex virus pathogenesis by IRF-3, and IRF-7 revealed through non-invasive bioluminescence imaging

Managing a child with an external ocular disease

Ganciclovir ophthalmic gel 0.15% for the treatment of acute herpetic keratitis: background, effectiveness, tolerability, safety, and future applications

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