acyclovir and Conjunctivitis--Viral

Childhood infectious diseases are not usually serious. The symptoms (fever, conjunctivitis, itching) diminish with the administration of antipyretic drugs. Cutaneous lesions leave no scarring. Sometimes complications may appear.

Topics: Acyclovir; Administration, Cutaneous; Antiviral Agents; Chickenpox; Child; Chorioretinitis; Conjunctivitis, Viral; Drug Therapy, Combination; Eye Infections, Viral; Glucocorticoids; Humans; Measles; Mumps; Pruritus; Rubella; Skin Diseases, Viral; Treatment Outcome

Acyclovir has been widely used against the various manifestations of eye disease due to herpes simplex since it first became generally available in the UK nearly five years ago. This paper discusses the rational indications for its use, through considerations of its pharmacology and pharmacokinetics, and through results of the many clinical trials that have been carried out to investigate its effects since its clinical efficacy was first demonstrated in 1979.

Topics: Acyclovir; Clinical Trials as Topic; Conjunctivitis, Viral; Corneal Ulcer; Herpes Simplex; Humans; Keratitis, Dendritic; Uveitis

Determinants of the natural history of recurrent herpes simplex virus (HSV) keratitis have not been consistently established. We assessed how previous HSV eye disease affects the risk of recurrent HSV keratitis and evaluated whether demographic and other variables play any predictive role.. Three hundred forty-six patients in the placebo group of the Herpetic Eye Disease Study's Acyclovir Prevention Trial who had experienced an episode of HSV eye disease in the previous year were followed up for 18 months. Recurrences were categorized according to the type of involvement. Relative rates of recurrence were compared for categories of demographic variables, types and number of previous ocular HSV episodes, previous nonocular HSV infection, and month of the year.. Fifty-eight (18%) of the 346 patients developed epithelial keratitis and 59 (18%) developed stromal keratitis during the 18 months of follow-up. Previous epithelial keratitis did not significantly affect the risk of epithelial keratitis (p = 0.84). In contrast, previous stromal keratitis increased the risk of stromal keratitis 10-fold (p < 0.001), and the risk was strongly related to the number of previous episodes (p < 0.001). Age, gender, ethnicity, and nonocular herpes were not significantly associated with recurrences, and no seasonal effects were observed.. Among patients who experienced active ocular HSV disease in the previous year, a history of epithelial keratitis was not a risk factor for recurrent epithelial keratitis. In contrast, previous, especially multiple, episodes of stromal keratitis markedly increased the probability of subsequent stromal keratitis.

Topics: Acyclovir; Adolescent; Adult; Aged; Antiviral Agents; Blepharitis; Child; Conjunctivitis, Viral; Corneal Stroma; Epithelium, Corneal; Female; Herpesvirus 1, Human; Humans; Iritis; Keratitis, Herpetic; Male; Middle Aged; Recurrence; Risk Factors

To compare the efficacy and safety of valaciclovir and acyclovir in immunocompetent patients with herpes zoster ophthalmicus.. A multicenter, randomized, double-masked study.. One hundred ten immunocompetent patients with herpes zoster ophthalmicus diagnosed within 72 hours of skin eruption were treated; 56 were allocated to the valaciclovir group and 54 to the acyclovir group.. Patients randomized to the valaciclovir group received two 500-mg tablets of valaciclovir three times daily and one tablet of placebo twice daily. Patients in the acyclovir group received one 800-mg tablet of acyclovir five times daily and one tablet of placebo three times daily for 7 days.. Main outcome measures included the frequency, severity, and duration of ocular complications, patient reports of zoster-associated pain, and the outcome of skin lesions. Tolerance was also assessed on the incidence and types of adverse effects and changes in laboratory parameters. The analysis was mainly descriptive and performed on an intent-to-treat basis.. Ocular complications of herpes zoster ophthalmicus were similar in the valaciclovir and acyclovir treatment groups. The main complications were conjunctivitis (54% and 52%, respectively), superficial keratitis (39% and 48%, respectively for punctate keratitis; 11% in each group for dendritic keratitis), stromal keratitis (13% in each group), and uveitis (13% and 17%, respectively). The long-term outcomes of these ocular complications were favorable and similar in both treatment groups. Pain duration and severity and outcome of skin lesions were similar between groups. Most patients reported prodromal pain. After 1 month, 25% of patients in the valaciclovir group and 31% in the acyclovir group still reported pain. The percentage of patients experiencing postherpetic neuralgia decreased during follow-up. The tolerance to acyclovir and valaciclovir was comparable and considered good. The most frequent adverse events were vomiting and edema of the eyelids or face (3%-5%). Three serious adverse events not linked to the study drugs occurred.. Valaciclovir is as effective as acyclovir in preventing ocular complications of herpes zoster ophthalmicus, including conjunctivitis, superficial and stromal keratitis, and pain. Tolerability of the two drugs is similar, but the dosing schedule of valaciclovir is simpler.

Topics: Acyclovir; Administration, Oral; Antiviral Agents; Conjunctivitis, Viral; Double-Blind Method; Female; Herpes Zoster Ophthalmicus; Humans; Immunocompetence; Keratitis; Male; Middle Aged; Pain; Safety; Tablets; Uveitis; Valacyclovir; Valine

Acyclovir has been widely used against the various manifestations of eye disease due to herpes simplex since it first became generally available in the UK nearly five years ago. This paper discusses the rational indications for its use, through considerations of its pharmacology and pharmacokinetics, and through results of the many clinical trials that have been carried out to investigate its effects since its clinical efficacy was first demonstrated in 1979.

Topics: Acyclovir; Clinical Trials as Topic; Conjunctivitis, Viral; Corneal Ulcer; Herpes Simplex; Humans; Keratitis, Dendritic; Uveitis

As the understanding of COVID-19 infection becomes better, it is being recognized as a complex multisystem pathology rather than just affecting the lungs. Several ocular findings have been documented by researchers in individuals infected with COVID-19, and ocular symptoms may even be the first presenting feature of COVID-19 infection in 2.26% individuals. Several countries have started vaccination with inactivated or live vaccines to combat this pandemic, and varied side effects have been reported after vaccination. Few cases of herpes zoster have previously been reported in elderly patients with comorbidities after receiving COVID-19 vaccines. In this article, the authors described 2 interesting cases of herpes zoster ophthalmicus (HZO) after receiving a live COVID-19 vaccine. The first case was a 35-year-old immunocompetent man who developed HZO 3 days postvaccine. The second case was a 40-year-old immunocompetent man who developed HZO 28 days postvaccine. To the best of our knowledge, no literature to date has described HZO after live vaccine.

Topics: Acyclovir; Administration, Ophthalmic; Administration, Oral; Adult; Anti-Bacterial Agents; Antiviral Agents; ChAdOx1 nCoV-19; Conjunctivitis, Viral; COVID-19; Drug Therapy, Combination; Herpes Zoster Ophthalmicus; Humans; Male; Moxifloxacin; SARS-CoV-2; Vaccination; Valacyclovir; Visual Acuity

To investigate the prevalence of ocular manifestations and visual outcomes in patients with herpes zoster ophthalmicus (HZO).. Consecutive cases diagnosed with HZO who attended 2 hospitals between July 1, 2011, and June 30, 2015, were retrospectively reviewed. Patient demographics, clinical presentations, and management were reviewed. The logistic regression model was used to estimate the odds ratio of visual loss with ocular manifestations.. A total of 259 patients were included. Of these, 110 (42.5%) patients were <60 years old and 149 patients (57.5%) were ≥60 years old. None of the patients had received zoster vaccination before presentation. Ocular manifestations were present in 170 (65.6%) patients with no difference between both age groups (P = 0.101). Conjunctivitis was the most common ocular manifestation, followed by anterior uveitis and keratitis. After resolution of HZO, 58.7% of patients had a visual acuity of 6/12 or worse. Epithelial keratitis and stromal keratitis were independent risk factors for visual loss after resolution of HZO (P = 0.003 and P = 0.004, respectively). The corresponding odds ratio was 6.59 [95% confidence interval (CI): 1.87-23.19] and 7.55 (95% CI: 1.88-30.30), respectively. The number of ocular manifestations was also associated with an increased risk of visual loss with an odds ratio of 1.49 (95% CI: 1.01-2.20; P = 0.043).. A substantial proportion of patients with HZO were <60 years old in this study. The absence of zoster vaccination across the study cohort was noteworthy. Keratitis was the main reason for poor visual outcome in these patients.

Topics: 2-Aminopurine; Acyclovir; Adult; Aged; Aged, 80 and over; Antiviral Agents; Conjunctivitis, Viral; Famciclovir; Female; Herpes Zoster Ophthalmicus; Hong Kong; Humans; Keratitis; Male; Middle Aged; Prevalence; Retrospective Studies; Uveitis; Vision Disorders; Visual Acuity; Young Adult

To describe 3 cases of herpes simplex virus (HSV) vesicular blepharitis that progressed to infectious epithelial keratitis despite treatment with oral acyclovir, but responded to topical antiviral therapy.. Retrospective review of a small case series.. One adult and 2 children presented with unilateral HSV vesicular blepharitis without evidence of corneal involvement. Each patient was placed on a therapeutic dose of oral acyclovir. While taking oral antiviral therapy, the patients developed HSV infectious epithelial keratitis, which was treated with trifluridine 1% solution 9 times daily in the adult and ganciclovir 0.15% ophthalmic gel 5 times daily in the 2 children. All 3 cases showed resolution of epithelial keratitis within 3 to 10 days after initiation of topical antiviral treatment while oral acyclovir was continued.. Oral antiviral therapy alone may not adequately prevent progression of infectious ocular HSV blepharoconjunctivitis. Topical antiviral therapy appeared to enable resolution of HSV epithelial keratitis that arose during oral acyclovir treatment.

Topics: Acyclovir; Administration, Oral; Administration, Topical; Adolescent; Adult; Antiviral Agents; Blepharitis; Child; Conjunctivitis, Viral; Disease Progression; Epithelium, Corneal; Eye Infections, Viral; Female; Ganciclovir; Humans; Keratitis, Herpetic; Male; Retrospective Studies; Trifluridine

To describe the clinical characteristics, treatment, and outcomes of herpes simplex virus (HSV) infections of the cornea and adnexae to raise awareness and to improve management of this important eye disease in children.. Retrospective case series.. Fifty-three patients (57 eyes) 16 years of age or younger with HSV keratitis (HSK), HSV blepharoconjunctivitis (HBC), or both in an academic cornea practice.. The following data were collected: age at disease onset, putative trigger factors, coexisting systemic diseases, duration of symptoms and diagnoses given before presentation, visual acuity, slit-lamp examination findings, corneal sensation, dose and duration of medications used, drug side effects, and disease recurrence.. Presence of residual corneal scarring, visual acuity at the last visit, changes in corneal sensation, recurrence rate, and manifestations of HSK were assessed in patients receiving long-term prophylactic systemic acyclovir.. The median age at onset was 5 years. Mean follow-up was 3.6 years. Eighteen eyes had HBC only; 4 patients in this group had bilateral disease. Of 39 eyes with keratitis, 74% had stromal disease. Thirty percent of HSK cases were misdiagnosed before presentation. Seventy-nine percent of patients with keratitis had corneal scarring and 26% had vision of 20/40 or worse at the last visit. Eighty percent of patients had recurrent disease. Six of 16 patients (37%) receiving long-term oral acyclovir had recurrent HSV, at least one case of which followed a growth spurt that caused the baseline dosage of acyclovir to become subtherapeutic.. In a large series, pediatric HSK had a high rate of misdiagnosis, stromal involvement, recurrence, and vision loss. Oral acyclovir is effective, but the dosage must be adjusted as the child grows.

Topics: 2-Aminopurine; Acyclovir; Administration, Topical; Adolescent; Age of Onset; Anterior Eye Segment; Antiviral Agents; Blepharitis; Child; Child, Preschool; Conjunctivitis, Viral; Eye Infections, Viral; Famciclovir; Female; Herpes Simplex; Herpesvirus 1, Human; Humans; Infant; Keratitis, Herpetic; Male; Ointments; Retrospective Studies; Trifluridine; Valacyclovir; Valine; Vidarabine

To provide an estimate of the incidence of herpes simplex virus (HSV) eye disease in a community-based cohort, and to investigate the effect of prophylactic oral antiviral therapy on HSV recurrences and outcomes.. All Olmsted County, Minnesota, residents diagnosed with ocular HSV from 1976 through 2007 were retrospectively reviewed. The frequency of recurrences and adverse outcomes, such as vision loss or need for surgery, were compared between untreated patients and those treated prophylactically with oral antiviral medication.. Three hundred ninety-four patients with ocular HSV were identified, yielding an annual incidence of 11.8 per 100,000 people (95% confidence interval [CI], 10.6-13.0). No trends in incidence or adverse outcomes were identified during the 32-year period. Oral antiviral therapy was prescribed in 175 patients. Patients were 9.4 times more likely (95% CI, 5.0-17.9) to have a recurrence of epithelial keratitis, 8.4 times more likely (95% CI, 5.2-13.7) to have a recurrence of stromal keratitis, and 34.5 times more likely (95% CI, 10.8-111.1) to have a recurrence of blepharitis or conjunctivitis if not being treated prophylactically at the time of the recurrence. Twenty patients experienced adverse outcomes, and 17 (85%) were not being treated with oral antiviral medications immediately preceding the adverse event.. Oral antiviral prophylaxis was associated with a decreased risk of recurrence of epithelial keratitis, stromal keratitis, conjunctivitis, and blepharitis due to HSV. Patients with adverse outcomes due to ocular HSV were usually not being treated with oral antiviral prophylaxis.

Topics: Acyclovir; Administration, Oral; Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Antiviral Agents; Blepharitis; Child; Child, Preschool; Conjunctivitis, Viral; Female; Follow-Up Studies; Humans; Incidence; Infant; Keratitis, Herpetic; Male; Middle Aged; Minnesota; Post-Exposure Prophylaxis; Risk Factors; Secondary Prevention; Sex Distribution; Treatment Outcome

We report a case of eczema herpeticum with unilateral ocular involvement in a 16-year-old boy. The patient has had a mild form of atopic dermatitis (AD) since early childhood. Why AD patients are prone to herpes simplex virus (HSV) infections is still unclear. Ocular pathologic findings in these cases are rarely reported.

Topics: Acyclovir; Adolescent; Antiviral Agents; Conjunctivitis, Viral; Dermatitis, Atopic; Humans; Kaposi Varicelliform Eruption; Male; Treatment Outcome

Herpes simplex virus ocular infections have been recognized as a major cause of corneal blindness in the developed world. The major signs of a primary infection are limited to the lids, conjunctiva, and cornea. Presence of a conjunctival dendrite without corneal involvement has been reported. Although conjunctival ulceration has been associated with recurrent attacks, it has not been documented as a manifestation of primary herpetic infection. We report a case of primary herpetic infection with geographic conjunctival ulcer with multiple corneal dendrites.

Topics: Acyclovir; Adult; Anti-Infective Agents; Antiviral Agents; Conjunctivitis, Viral; Herpes Simplex; Humans; Immunocompetence; Keratitis, Dendritic; Keratitis, Herpetic; Male; Ofloxacin; Ointments; Visual Acuity

To evaluate the effectiveness of more than 12 months of oral acyclovir therapy in reducing recurrences of ocular herpes simplex virus.. We retrospectively compared ocular herpes simplex virus recurrence in 2 groups of patients. In group 1, patients used oral acyclovir for at least 12 months and then discontinued the treatment. In group 2, patients received the treatment for at least 18 months. We compared recurrences when both groups were using acyclovir (period 1) and when only group 2 was receiving the drug (period 2). Statistical analysis was performed with the t test, chi2 test, and Kaplan-Meier method.. Group 1 had 18 patients and a mean +/- SD follow-up of 45.2 +/- 22.2 months. Group 2 had 22 patients and a mean +/- SD follow-up of 42.4 +/- 30.2 months. Six patients (33%) in group 1 and 4 patients (18%) in group 2 had recurrence in period 1 (P =.3). In period 2, 14 patients (78%) in group 1 and 8 patients (36%) in group 2 had recurrence (P =.01). Mean +/- SD recurrence-free survival in period 2 was 15.3 +/- 5.5 months in group 1 and 37.3 +/- 6.3 months in group 2 (P =.001).. Long-term oral acyclovir use seems to remain effective in decreasing the number of ocular herpes simplex virus recurrences beyond 12 months.

Topics: Acyclovir; Administration, Oral; Adult; Antiviral Agents; Blepharitis; Conjunctivitis, Viral; Disease-Free Survival; Female; Follow-Up Studies; Herpes Simplex; Humans; Iritis; Keratitis, Herpetic; Male; Middle Aged; Retrospective Studies; Secondary Prevention

Topics: Acyclovir; Administration, Oral; Aged; Aged, 80 and over; Antiviral Agents; Conjunctivitis, Viral; Diagnosis, Differential; Female; Giant Cell Arteritis; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Humans; Nose; Polymerase Chain Reaction

The incidence and severity of herpes zoster ophthalmicus have increased because of the growing number of immunocompromised patients. Uveitis and keratitis are the most common inflammatory complications. Corneal exposure from scarring and contraction of the upper lid may require reconstructive plastic surgery. Preliminary studies of oral acyclovir, specifically targeted at preventing ocular complications, are encouraging.

Topics: Acyclovir; Antiviral Agents; Conjunctivitis, Viral; Eyelid Diseases; Female; Herpes Zoster Ophthalmicus; Humans; Immune Tolerance; Keratitis; Male; Orbital Diseases; Retinal Diseases; United States; Uveitis, Anterior