Хронический рецидивирующий офтальмогерпес: опыт диагностики и комбинированной терапии

Chronic Recurrent Ophthalmoherpes: Experience in Diagnosis and Combination Therapy

Introduction. In recent years, there has been a global increase in the proportion of herpesvirus corneal lesions among the overall structure of keratitis. Ophthalmoherpes (OH) is a serious problem in ophthalmology due to its high rate of complications and vision loss. Purpose. To develop clinical and diagnostic algorithms, and to implement comprehensive etiotropic therapy for ophthalmoherpes and prevention of its recurrences. Materials and methods. The study involved 25 patients diagnosed with "Recurrent Herpetic Keratitis in the Acute Stage". Laboratory tests of tear fluid and saliva were performed using PCR to detect herpesvirus DNA (HSV, CMV, EBV, HHV-6), as well as ELISA to determine IgM and IgG antibodies, and the IgG avidity index. Etiotropic therapy included valacyclovir, valganciclovir, and recombinant interferon alfa-2b. Topical therapy involved instillations of antiviral, anti-inflammatory agents, and keratoprotectors. Results. Positive PCR results for herpesviruses were detected in tears (48%) and saliva (60%). The IgG avidity index (AI) for the viral capsid antigen (VCA) was less than 80%in 72%of cases. Conclusions. The use of PCR diagnostics is advisable at the first signs of a prolonged course of corneal inflammation to identify herpesvirus infection, which justifies the prescription of prolonged systemic antiviral therapy. The protracted and recurrent nature of keratitis may be associated with clinical activation of HSV1/2, CMV, and EBV, necessitating active reparative therapy from the first days of treatment in this patient category. Positive dynamics and active epithelialization of corneal defects indicate the correctness of the ophthalmologist’s management tactics. © 2025, Professionalnye Izdaniya. All rights reserved.