acyclovir and prednisolone-acetate

The objective of this study was to present a unique case of unilateral facial nerve palsy as an isolated complication of herpes zoster ophthalmicus. An 82-year-old immunocompetent male presented with a 1-week history of painful left scalp lesions. The diagnosis of left herpes zoster ophthalmicus with associated keratoconjunctivitis was established. A 7-day course of oral acyclovir (800 mg/day) along with topical prednisolone acetate 1% and moxifloxacin were started. Three weeks later, the ocular zoster involvement resolved and the vesicular lesions of the skin had regressed. However, the patient developed an isolated left Bell's palsy that gradually improved with conservative therapy. To the best of our knowledge, we present an unusual case of herpes zoster ophthalmicus complicated by an isolated ipsilateral Bell's palsy. The patient has had a near complete resolution of all symptoms after antiviral therapy for the zoster ophthalmicus component along with conservative management for the Bell's palsy.

Topics: Acyclovir; Aged, 80 and over; Antiviral Agents; Bell Palsy; Drug Therapy, Combination; Glucocorticoids; Herpes Zoster Ophthalmicus; Humans; Keratoconjunctivitis; Male; Prednisolone

Topics: Acyclovir; Administration, Cutaneous; Administration, Oral; Adult; Antiviral Agents; Betacoronavirus; Child; Coronavirus Infections; COVID-19; Drug Therapy, Combination; Female; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Humans; Male; Ophthalmic Solutions; Pandemics; Pneumonia, Viral; Prednisolone; SARS-CoV-2; Treatment Outcome; Virus Activation

The use of in vivo confocal microscopy has been valuable in detecting and managing corneal pathology. This case study documents endotheliitis using in vivo confocal microscopy where apparent resolution of endothelial edema on clinical examination resulted in the discovery of subclinical findings with confocal scanning. The purpose of this case study was to discuss a rare corneal pathology and the clinical value of confocal scanning.. A 30-year-old Asian Indian woman presented with unilateral endotheliitis and trabeculitis of presumed varicella zoster virus etiology. She was treated successfully with oral antiviral and topical corticosteroid therapy. Subclinical endotheliitis was detected using in vivo confocal microscopy, prompting the continuation of prophylactic, low-dose, topical corticosteroid therapy and topical hyperosmotics.. Further research is warranted to better understand the role of confocal microscopy in endotheliitis therapeutic management, endothelial cell count and morphology, and keratic precipitate characterization. To date, prophylactic oral antivirals and/or topical corticosteroids may play a role in immune suppression of the herpes virus, although prospective, randomized, controlled clinical trials have not focused specifically on endotheliitis cases.

Topics: Acyclovir; Adult; Anti-Inflammatory Agents; Antiviral Agents; Corneal Edema; Drug Therapy, Combination; Endothelium, Corneal; Eye Infections, Viral; Female; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Humans; Keratitis; Microscopy, Confocal; Prednisolone; Prospective Studies

Topics: Acyclovir; Aged, 80 and over; Antiviral Agents; Cell Count; Corneal Edema; Drug Therapy, Combination; Endothelium, Corneal; Glucocorticoids; Herpes Zoster Ophthalmicus; Herpes Zoster Vaccine; Humans; Male; Prednisolone; Uveitis, Anterior; Valacyclovir; Valine; Visual Acuity

Topics: Acyclovir; Adult; Biguanides; Corneal Stroma; Corneal Ulcer; Drug Therapy, Combination; Endothelium, Corneal; Eye Infections, Fungal; Female; Humans; Intraocular Pressure; Keratoplasty, Penetrating; Microsporidia; Microsporidiosis; Prednisolone; Visual Acuity

This retrospective study was designed to estimate the cumulative incidence of glaucoma in viral uveitis. Seventy-six consecutive patients with viral stromal keratouveitis were divided into two groups according to the etiologic agents herpes simplex virus (HSV) keratouveitis (n = 58) and herpes zoster virus (HZV) keratouveitis (n = 18). The groups were evaluated for the incidence and prognosis of ocular hypertension. Etiologic agents were determined with the help of clinical observation supported by the polymerase chain reaction (PCR) of aqueous humor. All patients received oral acyclovir therapy for at least six months and topical prednisolone in tapered doses. There was no significant difference in the recurrences of HSV and varicella zoster virus (VZV) keratouveitis between groups (P = 0.431). The total incidence of secondary glaucoma was 13.1%. Most of the patients responded to antiviral and antiglaucomatous therapy. Trabeculectomy with mitomycin C was performed in only two patients. Secondary glaucoma can be regarded as a frequent complication of viral uveitis. As it has a good prognosis, surgical intervention is rarely required.

Topics: Acyclovir; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Antiviral Agents; Female; Glaucoma; Herpesvirus 3, Human; Humans; Incidence; Intraocular Pressure; Male; Middle Aged; Prednisolone; Prognosis; Retrospective Studies; Simplexvirus; Uveitis, Anterior

We report the case of a 34-year-old man who had uncomplicated cataract surgery in his left eye. Medical history was significant for atopic dermatitis, requiring oral immunosuppressive medications. Two days after the surgery, the patient presented with pain, photophobia, decreased vision, and a small corneal abrasion. On postoperative day 5, the patient returned with left upper lid vesicular lesions and 2 corneal dendrites. Corrected vision was 20/100 OS, with intraocular pressure of 18 mm Hg and 1+ pigmented cells in the anterior chamber. Cultures of the lid lesions revealed herpes simplex virus (HSV) type 1. The patient was placed on oral acyclovir 800 mg 5 times a day. By day 8, the dendrites had resolved, and by day 15, the lid lesions healed over. HSV keratitis is an uncommon complication after cataract surgery. Ophthalmologists should be aware of the possibility of developing HSV keratitis even after the most routine cataract extraction.

Topics: Acyclovir; Administration, Oral; Adult; Anti-Inflammatory Agents; Antifungal Agents; Antiviral Agents; Cataract Extraction; Drug Administration Schedule; Drug Therapy, Combination; Eyelid Diseases; Herpes Simplex; Humans; Keratitis, Herpetic; Male; Postoperative Complications; Prednisolone; Treatment Outcome; Wound Healing

A 40-year-old woman presented with an unusual form of corneal herpetic reactivation 5 weeks after laser in situ keratomileusis. The cornea showed diffuse edema and a stromal ring infiltrate (disciform in appearance). Oral antiviral and topical steroids in tapered dosages were administered. The infiltrate disappeared within 6 weeks. Progressive improvement was also seen in all the parameters on Pentacam scans, including the pachymetry, keratometry readings, and elevation on the anterior float. Herpetic reactivation may occur in many forms after excimer laser ablation. Timely diagnosis and management is crucial to maintain good structural and visual outcomes. Pentacam analysis may serve as a useful adjunct in following the progression of herpetic reactivation cases.

Topics: Acyclovir; Adult; Antiviral Agents; Astigmatism; Cornea; Corneal Topography; Drug Therapy, Combination; Female; Glucocorticoids; Herpesvirus 1, Human; Humans; Keratitis, Herpetic; Keratomileusis, Laser In Situ; Lasers, Excimer; Myopia; Prednisolone; Virus Activation; Visual Acuity

The purpose of this study was to examine the importance of considering the differential diagnosis for patients with sectorial keratitis and uveitis by case summary and literature review.. A retrospective review of patients with sectorial keratitis and uveitis seen at the Ocular Immunology and Uveitis Service of the Massachusetts Eye and Ear Infirmary and a summary of the diagnoses of cases with similar ocular findings that have been reported in the literature.. Data on six patients with sectorial keratitis and uveitis were reviewed. Four patients were female and two were male, ages 21-50 years. All were eventually diagnosed with herpes simplex viral stromal sectorial keratitis. The corneal infiltrates were most common in the superior corneal quadrants, located in the posterior corneal layers. Anterior non-granulomatous uveitis was present in all cases. One case had bilateral ocular involvement. Five of the six patients responded to topical steroids and antiviral treatment. Immunomodulation with methotrexate, cyclosporine, and systemic prednisone was required in one patient. Glaucoma was a complication in six of the seven eyes. Five patients developed corneal scarring, localized in the anterior and mid-stroma.. The differential diagnosis of sectorial keratitis and uveitis is limited. The entities included in the differential are diverse; some of them threaten not only vision but also life. It is important for the ophthalmologist to be familiar with these entities, in order to pursue pertinent diagnostic investigations and arrive at an accurate diagnosis and institute appropriate management.

Topics: Acyclovir; Administration, Topical; Adult; Anti-Inflammatory Agents; Antiviral Agents; Corneal Stroma; Diagnosis, Differential; Female; Glucocorticoids; Humans; Keratitis, Herpetic; Male; Middle Aged; Prednisolone; Retrospective Studies; Uveitis, Anterior; Visual Acuity

To report a case of herpes zoster virus sclerokeratitis with anterior uveitis following vaccination with live attenuated varicella vaccine (Oka strain).. Case report.. The case records of the patient were reviewed retrospectively. Pertinent literature citations were identified using MEDLINE.. A 9-year-old boy presented with herpes zoster ophthalmicus 3 years following vaccination with live attenuated varicella vaccine (Oka strain). Examination of the affected eye revealed a moderate follicular response on the palpebral conjunctiva, decreased corneal sensation, mildly elevated intraocular pressure, diffuse anterior scleritis with marginal keratitis, and a moderately severe anterior uveitis. Amplified DNA from fluid taken from the base of a cutaneous vesicle produced wild-type varicella zoster virus (VZV) DNA, not Oka strain.. Herpes zoster virus infection needs to be considered in all patients who present with scleritis, keratitis, or anterior uveitis, regardless of their varicella vaccination status.

Topics: Acyclovir; Antiviral Agents; Chickenpox Vaccine; Child; Cyclopentolate; DNA, Viral; Drug Therapy, Combination; Glucocorticoids; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Humans; Keratitis; Male; Prednisolone; Scleritis; Trigeminal Nerve Diseases; Uveitis, Anterior; Vaccination

It is usual to consider chicken pox as a benign infectious disease with a few anterior segment ocular complications like conjunctivitis, keratitis, episcleritis, scleritis, iridocyclitis, and glaucoma. The retinal manifestations are necrotising retinitis, vitritis, neuroretinitis, and retinal detachments. We report a case of neuroretinitis following chicken pox in a 23-year-old male. The complication was resolved by treatment with oral acyclovir in combination with systemic steroids. This report highlights the necessity for fundus examination in cases of chickenpox exhibiting visual symptoms.

Topics: Acyclovir; Administration, Oral; Adult; Antiviral Agents; Chickenpox; Drug Therapy, Combination; Eye Infections, Viral; Glucocorticoids; Humans; Male; Prednisolone; Retinitis

To report a case of herpes simplex virus reactivation after starting bimatoprost treatment for glaucoma.. Interventional case report.. A 66-year-old woman had a herpes simplex keratouveitis reactivation that occurred within 1 month after starting bimatoprost. The herpes simplex had been inactive for more than 10 years.. Bimatoprost and prednisolone acetate 0.12% were discontinued; oral acyclovir, ofloxacin, and betaxolol 0.25% were initiated. Two weeks later, prednisolone acetate 1% was added. The reactivation resolved, and 1 month later, the best corrected visual acuity improved to 20/40.. Caution should be used in prescribing bimatoprost for patients with a history of herpes simplex virus keratitis.

Topics: Acyclovir; Aged; Amides; Anti-Infective Agents; Anti-Inflammatory Agents; Antihypertensive Agents; Antiviral Agents; Betaxolol; Bimatoprost; Cloprostenol; Drug Therapy, Combination; Female; Glaucoma; Herpesvirus 1, Human; Humans; Intraocular Pressure; Keratitis, Herpetic; Lipids; Ofloxacin; Prednisolone; Virus Activation; Visual Acuity

Topics: Acyclovir; Anti-Infective Agents; Antiviral Agents; Ciprofloxacin; Corneal Stroma; Drug Therapy, Combination; Glucocorticoids; Herpesvirus 1, Human; Humans; Keratitis, Herpetic; Male; Middle Aged; Ofloxacin; Prednisolone

Topics: Acyclovir; Antiviral Agents; Drug Therapy, Combination; Encephalitis, Viral; Eye Infections, Viral; Female; Herpes Simplex; Herpesvirus 1, Human; Humans; Middle Aged; Prednisolone; Prodrugs; Retinal Necrosis Syndrome, Acute; Tropanes; Vitreous Body

To report a case of uveitis associated with the live attenuated varicella virus vaccine (Varivax; Merck & Co, Inc, West Point, Pennsylvania) in a young, otherwise healthy girl.. The time of onset of uveitis in relation to vaccination and the number and the pattern of distribution of vesicles were noted. The patient received oral acyclovir and topical steroids and cycloplegic drops.. The uveitis and vesicular rash improved significantly after 7 days of treatment. A literature review and communications with the drug's manufacturer disclosed no identifiable previous cases of uveitis associated with Varivax.. Uveitis should be recognized as a possible adverse side effect of the varicella vaccine.

Topics: Acyclovir; Adolescent; Anterior Eye Segment; Chickenpox Vaccine; Drug Therapy, Combination; Female; Humans; Intraocular Pressure; Prednisolone; Uveitis, Anterior; Visual Acuity

The efficacy of combined acyclovir and steroid therapy in the treatment of herpetic stromal disease was evaluated by clinical evaluation of disease, the rebound of disease following termination of therapy, and the recovery of virus and viral DNA from corneas in a rabbit model. Therapy with acyclovir alone produced a significant reduction in corneal thickness in 10% of eyes. Addition of steroid to acyclovir therapy decreased the severity of stromal disease as measured by corneal thickness and increased the frequency of response to treatment to 63% of eyes. All eyes receiving acyclovir alone experienced rebound of disease following termination of therapy. Combined therapy increased the severity of rebound of corneal disease. Virus was recovered from cell cultures established after recovery from rebound in 50% of untreated and treated eyes. Viral DNA was detected by PCR in five of the nine corneal cultures which did not produce infectious virus.

Topics: Acyclovir; Animals; Antiviral Agents; Corneal Stroma; DNA, Viral; Drug Therapy, Combination; Glucocorticoids; Herpesvirus 1, Human; Keratitis, Herpetic; Male; Ophthalmic Solutions; Polymerase Chain Reaction; Prednisolone; Rabbits; Random Allocation; Recurrence; Trigeminal Ganglion; Virus Activation; Virus Shedding

The purpose of this study was to describe the clinical characteristics and course of peripheral ulcerative keratitis (PUK) secondary to herpes varicella-zoster virus in patients with the acquired immunodeficiency syndrome (AIDS). Three AIDS patients with ocular herpes zoster infection (mean age at onset, 33.0 years; range, 30-42) developed PUK. The three patients had skin involvement, and two of them had bilateral keratouveitis. All were treated with high-dose oral acyclovir (4 g/day) with or without topical antiviral therapy. Two of the patients responded well to oral acyclovir, but one of them stopped the treatment, and bilateral progressive outer retinal necrosis and lethal encephalitis developed. The third patient had a recurrent episode of inflammation with PUK, extensive stromal scarring, and deep neovascularization. AIDS patients with herpes varicella-zoster virus infection may have severe and protracted corneal manifestations, including PUK. The correct diagnosis and aggressive early long-term systemic antiviral treatment must be instituted to control inflammation, ulcer progression, and complications.

Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Administration, Oral; Adult; Anti-Inflammatory Agents; Antiviral Agents; Corneal Ulcer; Herpes Zoster Ophthalmicus; Humans; Male; Ophthalmic Solutions; Prednisolone; Recurrence; Skin Diseases, Viral; Uveitis

Three observations of typical patients with persistent and recurrent nummuli after epidemic keratoconjunctivitis serve--pars pro toto--to demonstrate that longterm therapy with high-dosed topical steroid offers no therapeutic solution. This experience and other disadvantages of steroids in KCE (dry eyes) lead us to recommend not to apply topical steroids in KCE unless an adenovirus specific antiviral agent has become available for basic antiviral therapy.

Topics: Acyclovir; Adult; Cornea; Dose-Response Relationship, Drug; Female; Humans; Keratoconjunctivitis; Male; Ophthalmic Solutions; Prednisolone; Virus Diseases; Visual Acuity

Topics: Acyclovir; Administration, Topical; Adult; Antigens, Viral; Drug Therapy, Combination; Endothelium; Female; Humans; Intraocular Pressure; Keratitis, Dendritic; Prednisolone; Simplexvirus; Timolol; Uveitis