Role of Prophylactic Oral Acyclovir in Recurrent Herpes Simplex Eye Disease
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 2
Abstract
Purpose: To study the role of long-term treatment with oral acyclovir to prevent recurrences of ocular HSV disease. Material & methods: A retrospective study was carried out in the Department of Ophthalmology at Government Medical College, Patiala, Punjab, India. A total of 50 immunocompetent patients who had had ocular HSV disease within the preceding year in the age group 25 to 45 years were selected to receive 400 mg of acyclovir orally twice daily over a period of 12 months. The history of each patient was taken including a record of age, sex, place of residence, change of place of residence, age at onset of the disease, best-corrected visual acuity was assessed and each patient was thoroughly examined with a slit lamp. Follow-up was done at 1, 3, 9 and 12 months during the treatment period and 6 weekly in the post-treatment observation period. The study outcomes were the rates of development of ocular HSV disease during a 12-month treatment period and a 6-month observation period. Results: The recurrence during the treatment period was 11 cases, (22 %) and the observation period was 8 cases (16 %). During 12 month treatment period, 1 case (2%) had blepharitis or conjunctivitis, 5 cases (10 %) had epithelial keratitis, 4 cases (8 %) had stromal keratitis and 1 case (2%) had iritis. During 6 month observation period, 2 cases (4%) had blepharitis or conjunctivitis, 3 cases (6 %) had epithelial keratitis, 2 cases (4 %) had stromal keratitis and 1 case (2%) had iritis. Conclusion: After the resolution of ocular HSV disease, 12 months of treatment with acyclovir reduces the rate of recurrent ocular HSV disease. Long-term oral acyclovir prophylaxis is most important for patients with a history of HSV stromal keratitis as it can prevent additional episodes and potential loss of vision.
Authors and Affiliations
Dr. Harvinder Nagpal, Dr. Mandeep Kaur
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