Document Detail


Primary treatment of acute retinal necrosis with oral antiviral therapy.
MedLine Citation:
PMID:  16996614     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To explore the possibility of oral antiviral therapy in lieu of intravenous acyclovir for treating acute retinal necrosis (ARN), a necrotizing retinopathy caused by herpes simplex virus type 1 or 2 or by varicella zoster virus. DESIGN: Retrospective, interventional, small case series. PARTICIPANTS: Four patients (6 eyes). METHODS: Patients were treated with oral antiviral therapy. Medications included valacyclovir (1 g 3 times daily), oral famciclovir (500 mg 3 times daily), and topical and oral corticosteroids. MAIN OUTCOME MEASURES: Improvement of symptoms, including photophobia, blurred vision, ocular discomfort, and floaters; increase in visual acuity; and resolution of vitreitis, retinitis, and retinal vasculitis, where present. RESULTS: Symptoms and visual acuity improved within 2 weeks to 1 month in 3 of 4 patients (75%) treated with oral antiviral medication. One patient required surgical treatment for asymptomatic retinal detachment after 3 weeks of treatment; retinal detachment in the fellow eye was repaired 2 months later. Duration of antiviral therapy ranged from 5 weeks to 3 months. CONCLUSIONS: For 4 patients with relatively indolent cases of ARN, oral antiviral therapy alone was effective in eliminating signs and symptoms of the disease. In particular, oral valacyclovir and famciclovir appeared to be effective, although further study is necessary to determine whether these drugs are as effective as intravenous acyclovir for initial treatment of ARN.
Authors:
Geoffrey G Emerson; Justine R Smith; David J Wilson; James T Rosenbaum; Christina J Flaxel
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-09-25
Journal Detail:
Title:  Ophthalmology     Volume:  113     ISSN:  1549-4713     ISO Abbreviation:  Ophthalmology     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-12     Completed Date:  2006-12-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2259-61     Citation Subset:  IM    
Affiliation:
Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA.
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MeSH Terms
Descriptor/Qualifier:
2-Aminopurine / analogs & derivatives*,  therapeutic use
Acyclovir / analogs & derivatives*,  therapeutic use
Administration, Oral
Adult
Aged
Antiviral Agents / therapeutic use*
Cytomegalovirus Retinitis / drug therapy*,  virology
Drug Therapy, Combination
Female
Glucocorticoids / therapeutic use
Herpes Simplex / drug therapy*,  virology
Herpes Zoster Ophthalmicus / drug therapy*,  virology
Herpesvirus 1, Human / isolation & purification
Herpesvirus 2, Human / isolation & purification
Herpesvirus 3, Human / isolation & purification
Humans
Male
Middle Aged
Retinal Necrosis Syndrome, Acute / drug therapy*,  virology
Retrospective Studies
Valine / analogs & derivatives*,  therapeutic use
Visual Acuity
Vitreous Body / virology
Chemical
Reg. No./Substance:
0/Antiviral Agents; 0/Glucocorticoids; 104227-87-4/famciclovir; 124832-27-5/valacyclovir; 452-06-2/2-Aminopurine; 59277-89-3/Acyclovir; 7004-03-7/Valine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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