Quality of vision in patients with herpetic keratitis

Purpose Patients with history of recurrent herpetic keratitis very often complain about their vision despite normal visual acuity (VA). The purpose of this study was to assess the optical aberrations and the quality of vision of the affected eye in patients with unilateral recurrent herpetic keratitis with preserved VA, and to compare these results with those of the non-affected eye. Methods Patients (n=15) with unilateral recurrent herpetic keratitis and an normal VA (Best corrected VA≤0 logMAR) were included in this study. Corneal optical aberrations of both eyes were assessed using dynamic skiascopy with OPD Scan II® (Nidek™). Wavefront analysis was performed during a quiescent period of the herpetic disease. The fellow eye was used as control. A blinded examiner retrospectively analyzed all the datas. Results The root mean square was significantly increased for high order aberrations (p=0.004) in the affected eye and particularly for trefoil and tetrafoil (p=0.004 and 0.02, respectively). In addition, The modulation transfer function (area under the curve) and the Strehl’s ratio were significantly lower in the affected eyes compared to the non affected eyes (p=0.02 and 0.02). Conclusion Our data show that herpetic keratitis induces wavefront abnormalities which could explain visual discomfort reported by patients with normal VA. A prospective study including more patients should provide further informations on the rate and the clinical significance of these optical aberrations.