Effect of oral valaciclovir on herpetic keratitis.

Abstract

PURPOSE:

To examine the efficacy of valaciclovir (VACV) oral formulation as an alternative to topical treatments in a case of herpetic keratitis.

METHODS:

The patient was a 61-year-old man who presented with dendritic keratitis in his left eye. After recognizing his difficulty in using eye ointment, we prescribed oral VACV 500 mg tablets twice daily for 7 days. We also describe our experiments with orally administered VACV in a mouse model of this disease. In this study, 143 Balb/c mice were inoculated with herpes simplex virus type 1 (HSV)-1 in each eye and treated with oral VACV 50 or 100 mg/kg twice daily, oral acyclovir (ACV) 50 mg/kg 5 times/d, 3% ACV eye ointment (ACV-O) 5 times/d, 3% ACV eye drops 5 times/d, or control for 5 days.

RESULTS:

After 7 days, the patient's lesion was observed healed. Corrected left visual acuity was also improved, and HSV DNA was below detectable level. In the mouse study, slit-lamp examination on days 3, 4, 5, and 7 revealed that all 5 ACV and VACV treatment groups were significantly more effective in improving symptoms of herpetic epithelial keratitis versus control (P < 0.05). Moreover, VACV 100 mg/kg was superior to other treatments. Viral titers in mouse eyeball and trigeminal ganglia were lowest in the VACV 100 mg/kg group versus other treatment groups.

CONCLUSION:

Our case example suggests that when frequent application, blurred vision, and foreign body sensation after ACV-O application cause difficulty for patients to follow treatment, oral VACV might be an effective and safe option for patients with herpetic keratitis.

• Authors: Shiro Higaki, Motoki Itahashi, Tatsunori Deai, Masahiko Fukuda, Yoshikazu Shimomura
• Journal: Cornea (Cornea) Vol. 25 Issue 10 Suppl 1 Pg. S64-7 (Dec 2006) ISSN: 0277-3740 [Print] United States
• PMID: 17001196 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents
• DNA, Viral
• Prodrugs
• Valine
• Valacyclovir
• Acyclovir

Topics

• Acyclovir (analogs & derivatives, therapeutic use)
• Administration, Oral
• Animals
• Antiviral Agents (therapeutic use)
• Cornea (virology)
• DNA, Viral (analysis)
• Disease Models, Animal
• Gene Dosage
• Herpesvirus 1, Human (genetics)
• Humans
• Keratitis, Dendritic (drug therapy, virology)
• Keratitis, Herpetic (drug therapy)
• Male
• Mice
• Mice, Inbred BALB C
• Middle Aged
• Polymerase Chain Reaction
• Prodrugs (therapeutic use)
• Valacyclovir
• Valine (analogs & derivatives, therapeutic use)