Famciclovir for ophthalmic zoster: a randomised aciclovir controlled study

Area of Science:

• Ophthalmology
• Virology
• Infectious Diseases

Background:

• Ophthalmic zoster, caused by the varicella-zoster virus, can lead to severe ocular complications.
• Antiviral medications are the cornerstone of treatment to prevent disease progression and complications.

Purpose of the Study:

• To compare the efficacy and safety of famciclovir versus aciclovir in treating ophthalmic zoster.
• To evaluate the incidence of ocular manifestations and visual acuity loss in patients treated with either famciclovir or aciclovir.

Main Methods:

• A randomized, double-masked, parallel-group study involving 454 patients with ophthalmic zoster (trigeminal nerve V1 involvement).
• Patients received oral famciclovir (500 mg three times daily) or oral aciclovir (800 mg five times daily) for 7 days.
• Ocular manifestations, severity, and visual acuity were assessed at multiple time points up to 6 months post-treatment.

Main Results:

• The proportion of patients experiencing ocular manifestations was similar between famciclovir (58.0%) and aciclovir (58.2%) groups (OR 0.99; 95% CI 0.68, 1.45).
• No significant differences were observed in the rates of severe or non-severe ocular manifestations between the two treatment groups.
• Visual acuity loss was comparable in patients receiving famciclovir or aciclovir.

Conclusions:

• Famciclovir 500 mg three times daily is a well-tolerated treatment option for ophthalmic zoster.
• Famciclovir demonstrated comparable efficacy to aciclovir in managing ophthalmic zoster and preventing ocular complications.