Oral acyclovir may be used to prevent recurrence of herpes simplex keratitis
LAS VEGAS — Recurrence of herpes simplex keratitis is commonly associated with corneal scarring and poor corneal graft survival. Early diagnosis and treatment helps prevent permanent corneal scarring caused by the virus’ lytic reaction and its immune-mediated response, according to a speaker here.
Daily applications of trifluridine 1% solution or ganciclovir 0.15% are commonly used to treat acute herpetic epithelial keratitis and have been shown to shorten the clinical course, Natalie Afshari, MD, said here at Cornea Subspecialty Day preceding the American Academy of Ophthalmology annual meeting.
“However, long-term use of topical antiviral treatments is often associated with corneal toxicity, and oral antivirals can be used alternatively as a treatment to avoid exposing the corneal epithelium to potential damage,” Afshari said.
According to the Herpetic Eye Disease Study, topical steroid use and antiviral agents were successful in reducing inflammation and the period of keratitis, but did not affect recurrent keratitis. “Oral acyclovir was beneficial in inhibiting the reoccurrences of keratitis,” she said.
“Long-term regimen of oral antiviral medication at the prophylactic maintenance dose are helpful in patients with reoccurrences of ocular HSV [herpes simplex virus] disease,” Afshari said.
HSV vaccination studies are ongoing, she said, “However, concerns remain that a boost in immune response to HSV after vaccination may exacerbate herpetic stromal keratitis.” — by Nhu Te
Afshari N. Herpes simplex virus: Treatment of acute and chronic disease. Presented at: The American Academy of Ophthalmology. Nov. 14, 2015; Las Vegas.
Disclosure: Afshari reports no relevant financial disclosures.