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KeratitisKeratitis of herpetic origin, which is common in Europe, is mostly caused by herpes simplex virus type I (HSV) and its appearance is like a chameleonChameleon. It can usually be treated successfully if the different, typically unilateral forms of this disease are known: 1. epithelial keratitisKeratitis (dendritica/geographica), 2. stromal keratitisKeratitis (necrotizing vs. non-necrotizing = “interstitial”), 3. endotheliitis (=“disciform keratitisDisciform keratitis”), 4. so-called “metaherpetic keratitisMetaherpetic keratitis” (=neurotrophic keratopathy), 5. (vascularized) corneal scars. The therapeutic regimenTherapeutic regimen is deliberately adapted to the form of appearance. Concomitant ocular hypertension should be treated primarily with medication in the acute stage (avoid prostaglandin analogues!). After keratoplastyKeratoplasty and in case of frequent severe keratitisKeratitis episodes, systemic acyclovir application (2 × 400 mg/day) for at least 1 year is the current standard!

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The Chameleon of “Herpetic Keratitis”—Different Manifestations Require Different Therapeutic Approaches

  • 章节

  • 发表日期：

    2025年

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  • Berthold Seitz,
  • Arnd Heiligenhaus

摘要

KeratitisKeratitis of herpetic origin, which is common in Europe, is mostly caused by herpes simplex virus type I (HSV) and its appearance is like a chameleonChameleon. It can usually be treated successfully if the different, typically unilateral forms of this disease are known: 1. epithelial keratitisKeratitis (dendritica/geographica), 2. stromal keratitisKeratitis (necrotizing vs. non-necrotizing = “interstitial”), 3. endotheliitis (=“disciform keratitisDisciform keratitis”), 4. so-called “metaherpetic keratitisMetaherpetic keratitis” (=neurotrophic keratopathy), 5. (vascularized) corneal scars. The therapeutic regimenTherapeutic regimen is deliberately adapted to the form of appearance. Concomitant ocular hypertension should be treated primarily with medication in the acute stage (avoid prostaglandin analogues!). After keratoplastyKeratoplasty and in case of frequent severe keratitisKeratitis episodes, systemic acyclovir application (2 × 400 mg/day) for at least 1 year is the current standard!