
STUDY GROUP
PUTERA Ikhwanuliman
THNG Zheng Xian
TESTI Ilaria
WESTCOTT Mark
CHEE Soon-Phaik
DICK Andrew
KEMPEN John
ZIERHUT Manfred
BODAGHI Bahram
THORNE Jennifer
BARISANI-ASENBAUER Talin
DE SMET Marc
SMITH Justine
MCCLUSKEY Peter
LA DISTIA NORA Rina
JABS Douglas
DE BOER Joke
SEN H. Nida
GOLDSTEIN Debra
KHAIRALLAH Moncef
DAVIS Janet
ROSENBAUM James
JONES Nicholas
NGUYEN Quan Dong
PAVESIO Carlos
AGRAWAL Rupesh
GUPTA Vishali
Purpose
To present current expert practice patterns and to formulate a consensus for management of HSV and VZV AU by uveitis specialists worldwide.
Methods
A two-round online modified Delphi survey with masking of the study team was conducted. Responses were collected from seventy-six international uveitis experts from 21 countries. Current practices in the diagnosis and treatment of HSV and VZV AU were identified. A working group (The Infectious Uveitis Treatment Algorithm Network [TITAN]) developed data into consensus guidelines. Consensus is defined as a particular response toward specific question meeting ≥ 75% of agreement or IQR ≤1 when a Likert scale is used.
Results
Unilaterality, increased intraocular pressure (IOP), decreased corneal sensation and diffuse or sectoral iris atrophy are quite specific for HSV or VZV AU from consensus opinion. Sectoral iris atrophy is characteristic of HSV AU. Treatment initiation is highly variable but most experts preferred valacyclovir owing to simpler dosing. Topical corticosteroids and beta-blockers should be used if necessary. Resolution of inflammation and normalization of IOP are clinical endpoints.
Conclusions
Consensus statements were reached on several aspects of diagnosis, choice of initial treatment and treatment endpoints for HSV and VZV AU. Treatment duration and management of recurrences varied between experts.