The course of stromal herpetic keratitis associated with various drug therapy regimens
DOI: 10.32364/2311-7729-2026-26-1-3
E.A. Kleshcheva1–3, G.M. Chernakova2,3, N.V. Mel'nikova1,2
1Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation
2S.P. Botkin City Clinical Hospital, Moscow, Russian Federation
3Herpetic Center LLC, Moscow, Russian Federation
Aim: a comparative analysis of the clinical course of stromal herpetic keratitis (HK) associated with various drug therapy regimens.
Materials and Methods: 36 patients (36 eyes) with stromal HK were enrolled. Laboratory diagnosis included a general blood test and molecular methods to confirm activity of herpes viruses. Herpesviral replication was verified by polymerase chain reaction (PCR). DNAs of herpes simplex virus, varicella-zoster virus, Epstein-Barr virus (EBV), cytomegalovirus, and human herpesviruses types 6 and 7 were tested in four biological fluids (i. e., tears, saliva, urine, and blood). The patients were divided into three groups depending on a treatment regimen. All the subjects received systemic therapy with famciclovir according to a tapering regimen (1500 mg/day with subsequent dose reduction within 30 days) and local anti-inflammatory therapy (bromfenac followed by fluorometholone). As a local immunotherapy, the Group I (n=13) received interferon α-2b, while the Group II (n=11) and the Group III (n=12) used eye drops representing a medication of the sum of polysaccharides of Solanum tuberosum shoots. In addition, the Group III received the latter systemically (i/v). Clinical and laboratory parameters were evaluated on Days 1 and 20.
Results: at baseline, the groups demonstrated comparable severity of the condition. On Day 20, the Groups II and III showed significantly (p<0.05) higher efficiency of the treatment strategy than the Group I. In particular, this was evidenced by following parameters: relief of conjunctival hyperemia and corneal syndrome; recovery of corneal tactile sensitivity (normal sensitivity: 81.8% and 75.0% in the Groups II and III, respectively, vs 15.4% in the Group I); corneal epithelialization confirmed by a significant decrease in incidence of a positive fluorescein test (18.2% and 8.1% in the Groups II and III, respectively, vs 61.5% in the Group I). Systemic nature of herpesvirus infection was verified by laboratory data in all patients. EBV replication was the most common in all groups (68.7%). In 71.9% of cases, mixed infection (i. e., a combination of several types of herpes virus) was detected. Combined therapy with the preparation of the sum of polysaccharides of Solanum tuberosum shoots (especially, in the Group III) showed the greatest efficiency in viral replication inhibition confirmed by a fast decrease in viral load according to PCR data on Day 20.
Conclusions: stromal HK is a manifestation of systemic herpesvirus infection indicating a comprehensive diagnostic and therapeutic approach. A treatment regimen containing an oral nucleoside analogue combined with systemic and topical administration of the medication of the sum of polysaccharides of Solanum tuberosum shoots was the best in inhibition of herpesviral replication.
Keywords: stromal herpetic keratitis, herpesviruses, herpes infection, ophthalmic herpes, antiviral therapy, famciclovir, sum of polysaccharides of Solanum tuberosum.
For citation: Kleshcheva E.A., Chernakova G.M., Mel'nikova N.V. The course of stromal herpetic keratitis associated with various drug therapy regimens. Russian Journal of Clinical Ophthalmology. 2026;26(1):17–24 (in Russ.). DOI: 10.32364/2311-7729-2026-26-1-3
About the authors:
Elena A. Kleshcheva — C. Sc. (Med.), Assistant Professor, Assistant Professor of the Department of Ophthalmology, Russian Medical Academy of Continuous Professional Education; 2/1, Barrikadnaya str., Moscow, 125993, Russian Federation; Ophthalmologist of the Moscow City Ophthalmological Center, S.P. Botkin City Clinical Hospital; 5, 2nd Botkinskiy pass., Moscow, 125284, Russian Federation; Ophthalmologist, Herpetic Center LLC; 10A, build. 2, Grimau str., Moscow, 117036, Russian Federation; ORCID iD 0000-0002-1392-3432
Galina M. Chernakova — C. Sc. (Med.), Assistant Professor, Head of Polyclinic Department No. 2, Moscow City Ophthalmological Center, S.P. Botkin City Clinical Hospital; 5, 2nd Botkinskiy pass., Moscow, 125284, Russian Federation; Ophthalmologist, 10A, build. 2, Grimau str., Moscow, 117036, Russian Federation; ORCID iD 0000-0002-9630
Natalia V. Mel'nikova — C. Sc. (Med.), Assistant Professor, Assistant Professor of the Department of Ophthalmology, Russian Medical Academy of Continuous Professional Education; 2/1, Barrikadnaya str., Moscow, 125993, Russian Fede-ration; Ophthalmologist of the Moscow City Ophthalmological Center, S.P. Botkin City Clinical Hospital; 5, 2nd Botkinskiy pass., Moscow, 125284, Russian Federation; ORCID iD 0000-0003-3917-0691
Contact information: Elena A. Kleshcheva, e-mail: klelen@mail.ru
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 17.12.2025.
Revised 12.01.2026.
Accepted 30.01.2026.
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