Prolonged Herpetic Keratitis in Chronic Sinusitis and Tonsillitis: Experience of Practical Solutions

• Published in: Oftalmologii͡a Vol. 19; no. 4; pp. 875 - 884
• Main Authors: Chernakova, G. M., Kleshcheva, E. A., Turdalieva, Z. D., Shchegoleva, V. I.
• Format: Journal Article
• Language: English; Russian
• Published: Ophthalmology Publishing Group 03-01-2023
• Subjects: herpesviruses; herpetic keratitis; miramistin; okomistin; pcr; sinusitis; tonsillitis
• ISSN: 1816-5095; 2500-0845
• DOI: 10.18008/1816-5095-2022-4-875-884

Aim:
to describe the experience of practical solutions for herpetic keratitis of a protracted course with latent chronic sinusitis and tonsillitis.
Material and methods.
We observed 111 patients with various forms of prolonged herpetic keratitis and inflammatory ENT pathology. All patients underwent a study of biological secretions (tear, saliva, blood and urine) for the presence of DNA of herpetic viruses by PCR, systemic antiviral therapy was prescribed. All patients underwent a standard otorhinolaryngological examination, СТ scan of the paranasal sinuses (if necessary), microbiological study of nasopharynx swabs. Local therapy of herpetic keratitis included anti-inflammatory and antibacterial components.
Results and discussion.
Isolated sinus inflammation occurred in 59 % of cases (65 patients), in 38 % of cases (42 patients) there were variants of combinations of sinus inflammation (sinusitis, sphenoethmoiditis, pansinusitis). In 24 % of those included in the study (n = 27), during examination, in addition to the presence or absence of sinusitis, chronic tonsillitis was determined. In 30 % of cases (more often than in other secrets), herpetic viruses were detected in saliva, coccal flora dominated in swabs from the nasopharynx. A marked reduction in ophthalmological symptoms correlated with start of ENT therapy.
Conclusions.
This clinical and laboratory study has showed a close pathogenetic relationship of anterior ophthalmic herpes and concomitant inflammatory pathology of the paranasal sinuses and oropharynx. Active ethiotropic therapy of sinusitis and tonsillitis promotes short-term reduction of ophthalmic symptoms.