Can corticosteroids get you aHEaD of the curve for HSV stromal keratitis? In the HEDS trial, patients with active herpes simplex stromal keratitis were randomly assigned to either a placebo group (n = 49) or topical prednisolone phosphate group (n = 57). Both groups received topical trifluridine and a 10-week tapered regimen of the treatment drug/placebo.
Overall, this subset of the HEDS is a landmark study because it demonstrated how administering topical corticosteroids were efficacious in treating herpes simplex stromal keratitis. Before this trial, it was unclear whether topical corticosteroids were safe and effective for these patients. In the HEDS, researchers found steroids were specifically advantageous in hindering the progression of stromal inflammation and shortening the duration of stromal keratitis.
- Compared to placebo, the steroid group had a reduced risk of persistent stromal keratouveitis by 68%.
- The time to resolution was significantly shorter in the steroid group.
- At 6 months, there were no clinically or statistically significant differences in visual outcome or recurrent herpetic eye disease between both groups.