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Ocular manifestations of herpes simplex virus

Valerio, Gabriel S.; Lin, Charles C.

Current Opinion in Ophthalmology: November 2019 - Volume 30 - Issue 6 - p 525–531
doi: 10.1097/ICU.0000000000000618

Purpose of review To review ocular manifestations and complications of herpes simplex virus (HSV) and discuss recent advancements in diagnostic and treatment strategy.

Recent findings In-vivo confocal microscopy has expanded our understanding of corneal nerve degeneration, corneal dendritic cell activity, and changes in biomechanical properties in HSV keratitis. Although currently available only as a research tool, metagenomic deep sequencing has the potential to improve diagnostic accuracy beyond the well established PCR technology, especially in atypical cases. Development of an HSV vaccine has shown some encouraging results in a murine model. New treatment options for neurotrophic cornea offer promise, specifically cenegermin nerve growth factor.

Summary Ocular herpes simplex infection and its complications continue to cause significant visual burden and decreased quality of life. Familiarity with its clinical features, wider adoption of viral PCR diagnostic technology, and recognition of the need for long-term maintenance medications for recurrent or chronic cases form the basis for effective management. Metagenomic deep sequencing, the development of a herpes vaccine, and cenegermin nerve growth factor offer promise as diagnostic, preventive, and therapeutic options, respectively.

Byers Eye Institute, Stanford University, Palo Alto, California, USA

Correspondence to Charles C. Lin, MD, Clinical Assistant Professor, Byers Eye Institute - Stanford University, 2452 Watson Court, Palo Alto, CA 94303, USA. Tel: +1 650 4979118; e-mail:

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