Antiviral update

Area of Science:

• Ophthalmology
• Virology
• Pharmacology

Background:

• Ocular herpes infections pose a significant threat to vision.
• Existing antiviral treatments for ocular herpes include idoxuridine and vidarabine (Ara-A).

Purpose of the Study:

• To review the efficacy and toxicity of current antiviral agents for ocular herpes.
• To discuss the potential of newer, more selective antiviral drugs for ocular herpes treatment.

Main Methods:

• Review of existing literature on antiviral agents for ocular herpes.
• Comparison of effectiveness, toxicity, and selectivity of idoxuridine, vidarabine, trifluorothymidine, and acycloguanosine.

Main Results:

• Idoxuridine and vidarabine (Ara-A) are similar in topical efficacy and toxicity; vidarabine offers systemic activity for deep ocular disease.
• Trifluorothymidine, an experimental drug, demonstrates superior potency in clinical trials.
• Current drugs lack selectivity, affecting both viral and host cellular functions.
• Acycloguanosine shows promise as a selective antiviral agent for herpes virus-infected cells.

Conclusions:

• While idoxuridine and vidarabine are established treatments, their lack of selectivity is a limitation.
• Trifluorothymidine represents a more potent option for ocular herpes.
• Acycloguanosine and similar selective agents are the future of ocular herpes antiviral therapy, offering improved safety and efficacy.