Twenty years since the Herpetic Eye Disease Study: Lessons, developments and applications to clinical practice

Herpes Simplex Virus (HSV) is the most common virus that causes eye disease. Although around 60% of the world's population are seropositive for HSV antigens, fortunately, it is estimated that only 1% of seropositive individuals develop eye disease. The most common ocular manifestation of HSV is...

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Bibliographic Details
Published in:Clinical and experimental optometry 2021-04, Vol.104 (3), p.396-405
Main Authors: Arshad, Sana, Petsoglou, Constantinos, Lee, Taehwan, Al-Tamimi, Abdullah, Carnt, Nicole A.
Format: Article
Language:English
Subjects:
Antigens
Clinical medicine
Clinical trials
Eye diseases
Herpes simplex
Herpes simplex keratitis
herpes simplex virus
Herpetic Eye Disease Study
Keratitis
Latency
Rehabilitation
Risk factors
Serology
Uveitis
Viruses
Vision
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Summary:Herpes Simplex Virus (HSV) is the most common virus that causes eye disease. Although around 60% of the world's population are seropositive for HSV antigens, fortunately, it is estimated that only 1% of seropositive individuals develop eye disease. The most common ocular manifestation of HSV is keratitis, while uveitis and retinal necrosis occur in a small number of cases. HSV keratitis is a debilitating disease, for several reasons: pain , photophobia, and vision loss in acute disease, latency of the virus which leads to infection reactivation from various triggers, scarring, and neovascularisation, leading to permanent vision loss with poor visual rehabilitation prospects. The Herpetic Eye Disease Study (HEDS) was a landmark series of randomised controlled trials in the 1990s that set the benchmark for evidence-based treatment guidelines for anterior eye herpetic disease. Since this time, there has been a change in the distribution of seroprevalence of herpes in the community, a simplified diagnostic classification, advances in treatment options, an emergence of new and a better understanding of risk factors, and discoveries in science that show promise for vaccine and novel future treatments. However, many of the principles of the HEDS study remain rightly entrenched in clinical practice. In this article, the HEDS study is revisited 20 years on through the lens of published literature, to determine current best practise and look towards the future.
ISSN:0816-4622
1444-0938
DOI:10.1080/08164622.2021.1877531