brivudine and Uveitis

A therapeutic trial with topical bromovinyldeoxyuridine (BVDU) plus low-dosage steroids was conducted in five patients with chronic zoster keratouveitis, who had previously received topical acyclovir (ACV) and steroids. In all cases, BVDU (plus steroids) was found to be superior to ACV (plus steroids). Yet BVDU was not able to keep the patients from having chronic relapsing varicella-zoster keratouveitis. This can probably be explained by pathophysiological reasons, i.e., the persistence and low-grade multiplication of the varicella-zoster virus in peripheral eye tissues during the chronic carrier stage. It is possible that this chronic carrier status could be obviated by vigorous antiviral treatment during the acute phase of the illness.

Topics: Administration, Topical; Adult; Bromodeoxyuridine; Chronic Disease; Clinical Trials as Topic; Dexamethasone; Drug Therapy, Combination; Female; Herpes Zoster Ophthalmicus; Humans; Keratitis; Male; Middle Aged; Ophthalmic Solutions; Pilot Projects; Recurrence; Uveitis

As has been established in rabbits, (E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU) is superior to 5-iodo-2'-deoxyuridine (IDU) in the topical treatment of epithelial HSV-1 (herpes simplex virus type 1) keratitis, and superior to 5-trifluoromethyl-2'-deoxyuridine (TFT) in the topical treatment of deep stromal HSV-1 keratitis and HSV-1 uveitis. BVDU 0.1% eye drops have also proven efficacious in the treatment of patients with dendritic corneal ulcers, geographic corneal ulcers and stromal keratitis, and combined treatment of BVDU 0.1% eye drops with oral BVDU at 375 mg/day for 5 days led to a prompt healing of keratouveitis and skin lesions in patients with ophthalmic herpes zoster.

Topics: Animals; Bromodeoxyuridine; Herpes Simplex; Herpes Zoster Ophthalmicus; Humans; Keratitis; Keratitis, Dendritic; Rabbits; Uveitis