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Acyclovir in herpetic anterior uveitis.

J Colin1, F Malet, C Chastel

  • 1Department of Ophthalmology, Brest University Hospital, France.

Annals of Ophthalmology
|January 1, 1991
PubMed
Summary
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Antiviral therapy with acyclovir may be a primary treatment for herpetic anterior uveitis. Patients not previously treated with corticosteroids showed better outcomes, suggesting a shift in herpes simplex keratitis management.

Area of Science:

  • Ophthalmology
  • Virology
  • Immunology

Background:

  • Herpes simplex stromal keratitis and uveitis management remains controversial.
  • Herpetic anterior uveitis requires effective treatment strategies to prevent vision loss.
  • Corticosteroid use in herpetic eye disease can be associated with complications.

Purpose of the Study:

  • To evaluate the efficacy of antiviral therapy as a first-line treatment for herpetic anterior uveitis.
  • To compare patient outcomes with and without prior corticosteroid use during antiviral treatment.
  • To assess the role of acyclovir in managing herpetic keratouveitis.

Main Methods:

  • A study involving 32 patients with presumptive herpetic anterior uveitis without active corneal inflammation.
  • Patients received a regimen of 3% acyclovir ophthalmic ointment and oral acyclovir (200mg) five times daily.

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  • Patient outcomes were analyzed based on previous corticosteroid exposure.

    • Main Results:

    • A significantly higher rate of deterioration was observed in patients who had previously received corticosteroids (44.4%) compared to those who had not (7.1%) within the first five days of therapy (P < .05).
    • Mean healing times were comparable between the groups with and without prior corticosteroid use.
    • Antiviral therapy demonstrated a potential benefit in managing herpetic keratouveitis.

    Conclusions:

    • Antiviral therapy, specifically acyclovir, may serve as a first-line treatment for herpetic keratouveitis in patients not previously treated with corticosteroids.
    • Prior corticosteroid use appears to be a risk factor for worsening during antiviral therapy for herpetic anterior uveitis.
    • These findings suggest a need to reconsider treatment protocols for herpetic eye disease, prioritizing antiviral agents.