acyclovir and prednisolone-phosphate

Herpes simplex virus (HSV) is a leading cause of chronic infectious ocular disease in the United States. The morbidity from recurrent herpetic episodes is high, and the resultant corneal scarring may require penetrating keratoplasty for visual rehabilitation. Effective treatments for acute episodes of HSV have been verified by early Herpetic Eye Disease Study (HEDS) trials. The recent HEDS trial on the efficacy of oral acyclovir as prophylaxis against recurrent stromal keratitis represents the first report of a treatment likely to reduce long-term scarring from herpetic disease. This article reviews all the HEDS trials and the implications of their findings for the management of patients with ocular HSV.

Topics: Acyclovir; Administration, Oral; Antiviral Agents; Corneal Stroma; Humans; Iritis; Keratitis, Herpetic; Prednisolone; Randomized Controlled Trials as Topic; Recurrence; Trifluridine

A 17-year-old youth presented with bilateral follicular conjunctivitis and nummular subepithelial corneal infiltrates. Failure of this to settle in an outpatient setting led to corneal scraping with microscopy and culturing for bacteria, fungi, Herpes simplex, adenovirus and Acanthamoeba as an inpatient. Polymerase chain reaction analysis of corneal cells was positive for adenovirus, and culture on live Escherichia coli-coated agar plates was positive for Acanthamoeba by phase contrast microscopy on day two. We conclude that Acanthomoeba infection can complicate adenoviral keratoconjunctivitis. This observation is in keeping with previously reported modes of infection by Acanthamoeba, whereby any epithelial breach seems to allow inoculation of the eye by this opportunistic organism.

Topics: Acanthamoeba; Acanthamoeba Keratitis; Acyclovir; Adenovirus Infections, Human; Adenoviruses, Human; Adolescent; Animals; Biguanides; Cyclopentolate; Drug Therapy, Combination; Eye Infections, Viral; Humans; Keratoconjunctivitis; Male; Prednisolone