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Herpes Simplex and Herpes Zoster

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Uveitis

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Abstract

The herpes virus family is ubiquitous in the population and causes a wide spectrum of ocular disease. The name herpes originates from the Greek word herpein, meaning to creep reflecting both creeping/spreading nature of skin lesions associated with many members of the herpes virus family and the ability of the virus to remain latent prior to causing recurring infections in their host. The use of this term dates back to ancient Greece, confirming the longevity and hardiness of this viral family. The herpesviridae family each share the common structure of double-stranded DNA (dsDNA) enclosed by a viral envelope. All are nuclear replicating, with viral DNA being transcribed to mRNA within an infected cell. Once a person is infected, generally by close physical contact, the virus remains viable for life and can reactivate at any time following the primary infection. There are eight known herpes virus types that affect humans: herpes simplex virus 1 (HSV-1), herpes simplex virus 1 (HSV-2), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein--barr virus (EBV), human herpes virus 6, and human herpes virus 8. The first four are most likely to cause ocular disease. Ocular disease caused by the herpesviridae family can occur either in the anterior or posterior segment and includes some of the most devastating forms of retinitis. The pattern and presentation of disease is related to the immune status of the patient with the severely immunocompromised at greatest risk for developing a severe necrotizing retinitis. Treatment is based on the location of disease with anterior segment disease managed with a combination of systemic antivirals and topical agents. Posterior segment disease always requires systemic antiviral therapy and local therapy with intravitreal injections of antiviral medications in selected patients. Atypical cases of herpes virus associated disease often lead to delay in diagnosis. However, the increasing availability of PCR analysis of intraocular fluids has increased our diagnostic efficiency. To benefit from this improved technology and advances in treatment, it is critical to maintain a high level of clinical suspicion for this virus in all cases of ocular inflammation.

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Authors and Affiliations

  1. 35 Eastward Ln, Ellsworth, ME, 04605, USA

    Thomas Flynn

  2. Department of Ophthalmology, Drexel College of Medicine, 219 N Broad Street, 3rd Floor, Philadelphia, PA, 19106, USA

    Jessica Ackert

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  1. Thomas Flynn
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Correspondence to Thomas Flynn .

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Editors and Affiliations

  1. Ocular Immunology and Uveitis Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA

    George N. Papaliodis

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Flynn, T., Ackert, J. (2017). Herpes Simplex and Herpes Zoster. In: Papaliodis, G. (eds) Uveitis. Springer, Cham. https://doi.org/10.1007/978-3-319-09126-6_6

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  • DOI: https://doi.org/10.1007/978-3-319-09126-6_6

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