TY - JOUR
T1 - Practice patterns for herpes simplex keratitis
T2 - A survey of ophthalmologists in Gulf Coast countries
AU - Alkhayyal, Mashael A.
AU - Stone, Donald U.
N1 - Publisher Copyright:
© 2017
PY - 2017/4
Y1 - 2017/4
N2 - Purpose Herpes simplex is a common cause of visual disability, and there are published evidence-based guidelines for therapy. This survey aims to determine the preferred practice patterns of ophthalmologists in Gulf Coast Countries regarding herpetic eye disease, as well as identify areas of controversy or barriers to acceptance of evidence-based protocols. Methods Anonymous web-based survey of ophthalmologists in Saudi Arabia, Bahrain, the United Arab Emirates, and Oman. Results There were 48 responses to the survey. For a first episode of epithelial dendritic keratitis, 28.2% reported “observation” rather than specific therapy. The majority of respondents utilize oral or topical antiviral for epithelial keratitis, with oral antiviral being the most popular (43.6%). The majority also included a corticosteroid with antiviral for stromal keratitis (83.9%) or iritis (70.3%). Over 90% prescribe a prophylactic antiviral after keratoplasty for herpetic eye disease, although the length of therapy ranged widely from <6 months to indefinite. The perceived risk of recurrent disease was ranked as the most important factor when considering antiviral prophylaxis, followed by risk of adverse effects. Topical cyclosporine was utilized “never or almost never” by 76.9% of respondents. Conclusions Most respondents report following evidence-based guidelines. There was less consensus in areas where there are remaining knowledge gaps, such as the length of antiviral prophylaxis after keratoplasty and the potential role for topical cyclosporine.
AB - Purpose Herpes simplex is a common cause of visual disability, and there are published evidence-based guidelines for therapy. This survey aims to determine the preferred practice patterns of ophthalmologists in Gulf Coast Countries regarding herpetic eye disease, as well as identify areas of controversy or barriers to acceptance of evidence-based protocols. Methods Anonymous web-based survey of ophthalmologists in Saudi Arabia, Bahrain, the United Arab Emirates, and Oman. Results There were 48 responses to the survey. For a first episode of epithelial dendritic keratitis, 28.2% reported “observation” rather than specific therapy. The majority of respondents utilize oral or topical antiviral for epithelial keratitis, with oral antiviral being the most popular (43.6%). The majority also included a corticosteroid with antiviral for stromal keratitis (83.9%) or iritis (70.3%). Over 90% prescribe a prophylactic antiviral after keratoplasty for herpetic eye disease, although the length of therapy ranged widely from <6 months to indefinite. The perceived risk of recurrent disease was ranked as the most important factor when considering antiviral prophylaxis, followed by risk of adverse effects. Topical cyclosporine was utilized “never or almost never” by 76.9% of respondents. Conclusions Most respondents report following evidence-based guidelines. There was less consensus in areas where there are remaining knowledge gaps, such as the length of antiviral prophylaxis after keratoplasty and the potential role for topical cyclosporine.
KW - Antiviral
KW - Herpes simplex
KW - Keratitis
KW - Practice pattern
KW - Stromal keratitis
KW - Survey
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U2 - 10.1016/j.sjopt.2017.03.007
DO - 10.1016/j.sjopt.2017.03.007
M3 - Article
C2 - 28559714
AN - SCOPUS:85018962266
SN - 1319-4534
VL - 31
SP - 61
EP - 64
JO - Saudi Journal of Ophthalmology
JF - Saudi Journal of Ophthalmology
IS - 2
ER -