Valacyclovir in the treatment of acute retinal necrosis.

Abstract

BACKGROUND:

To report the outcome of oral valacyclovir as the sole antiviral therapy for patients with acute retinal necrosis (ARN).

METHODS:

This study reports a retrospective, interventional case series of nine consecutive patients with ten eyes with newly diagnosed ARN treated with oral valacyclovir as the sole antiviral agent. Eight patients received oral valacyclovir 2 g tid (Valtrex, GlaxoSmithKline) and one patient with impaired renal function received oral 1 g tid. The main outcome measures were response to treatment, time to initial response to treatment, time to complete resolution of retinitis, best corrected visual acuity (BCVA) at final follow-up, retinal detachment and development of recurrent or second eye disease.

RESULTS:

Retinitis resolved in ten of ten (100%) affected eyes. The median time to initial detectable response was seven days and the median time to complete resolution was 21 days. A final BCVA of 20/40 or better was achieved in 6/10 (60%) of eyes. 3/10 eyes (30%) developed a retinal detachment. No patients developed either disease reactivation or second eye involvement over the course of the study (mean follow up 31 weeks, range 7 to 104 weeks).

CONCLUSIONS:

Treatment with oral valacyclovir as the sole antiviral therapy resulted in complete resolution of retinitis. Final BCVA and retinal detachment rate were comparable with previously reported outcomes for intravenous acyclovir.

• Authors: Simon Rj Taylor, Robin Hamilton, Claire Y Hooper, Lavnish Joshi, Jiten Morarji, Nitin Gupta, Sue L Lightman
• Journal: BMC ophthalmology (BMC Ophthalmol) Vol. 12 Pg. 48 (Sep 05 2012) ISSN: 1471-2415 [Electronic] England
• PMID: 22947428 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents
• Prodrugs
• Valine
• Valacyclovir
• Acyclovir

Topics

• Acyclovir (administration & dosage, analogs & derivatives)
• Administration, Oral
• Adult
• Aged
• Aged, 80 and over
• Antiviral Agents (administration & dosage)
• Dose-Response Relationship, Drug
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Prodrugs
• Retinal Necrosis Syndrome, Acute (diagnosis, drug therapy)
• Retrospective Studies
• Treatment Outcome
• Valacyclovir
• Valine (administration & dosage, analogs & derivatives)
• Visual Acuity