The use of combined interferon alpha-2b-based medicine in the complex treatment of herpetic keratitis in patients after coronavirus infection

Abstract

Purpose: to assess the effectiveness of the combined interferon alpha-2b-based medicine (Ophtalmoferon, eye drops) in the complex treatment of herpetic keratitis in patients who had coronavirus infection caused by SARS-CoV-2.Materials and methods. The study group included 53 people aged 18 to 74 years (mean age 46.0 ± 7.8 years) with the following complaints: decreased vision, redness, eye pain, lacrimation, photophobia and foreign body sensation under the eyelid. Criteria for selection and inclusion of patients were: typical for herpetic keratitis corneal infiltrates detected by biomicroscopy; herpetic infection detected by Polymerase Chain Reaction (PCR) in the affected eye corneal scrape; a medical history of the novel coronavirus infection confirmed by PCR. The patients were divided into two groups. Group 1 (n = 32) received complex treatment with the combined interferon alpha-2b-based medicine (Ophtalmoferon®, eye drops) at early stages of the disease (from the 1st to 7th day after the first complaints). Group 2 (n = 21) received complex treatment with Ophtalmoferon® at later stages (from the 14th day of the first complaints). The effectiveness and tolerability of Ophtalmoferon were assessed during the dynamic monitoring of the patients.Results. A positive trend was noted in 79.2 % (n = 42) of all patients who received Ophtalmoferon for the complex treatment of herpetic keratitis: a gradual improvement in visual acuity, reduction or disappearance of photophobia, lacrimation and eye pain. In 20.8 % (n = 11) of all cases, mostly related to the late start of etiological therapy, the treatment effectiveness was lower, the disease lasted longer and was accompanied by the involvement of the choroid, the development of more severe opacities in the place of corneal infiltrates. Due to later start of etiotropic therapy the inflammatory process affected deeper layers of the cornea up to the development of corneal ulcer with perforation, which required surgical intervention.Conclusion. The etiotropic treatment of herpetic keratitis in patients after COVID-19, if started in the first days of the disease, can quickly stop the inflammatory process and prevent its spread to deeper layers of the cornea. Ophtalmoferon is a highly effective medicine for etiotropic treatment of keratitis caused by herpesviruses. Due to high patient compliance, Ophtalmoferon can be recommended for wide use in the complex therapy of herpetic keratitis.