Comparison of Efficacy of Oral Valacyclovir and Topical Acyclovir in the Treatment of Herpes Simplex Keratitis: A Randomized Clinical Trial

Abstract

Thirty eyes of 28 patients with herpetic disease were included in the study. Group 1 patients (15 eyes of 15 subjects) received topical acyclovir (ACV) ointment. Oral valacyclovir (VACV) was prescribed to group 2 (15 eyes of 13 patients). The anterior segment of each eye was carefully examined by slit lamp and scored. Each patient was also instructed to grade his/her subjective symptoms. The corneal lesion healed significantly faster in the group 2 eyes compared to the group 1 eyes. Photophobia score on day 3 and slit-lamp score on day 10 were at significantly lower levels in group 2 compared to group 1. In herpetic keratitis, oral VACV can be a good alternative to ACV ointment therapy.

Ocular Herpes Simplex Virus: How are Latency, Reactivation, Recurrent Disease and Therapy Interrelated?

“…Complex decision making is involved in selecting appropriate therapy for ocular herpes [232]. Tables 5–7 summarize human, rabbit and mouse antiherpetic studies [60,164,233–254]. …”

Is herpes simplex virus keratitis a different disease in children?

“…4,7,8 Oral anti-virals can be used in the treatment of HSV infections. Sozen, Ayundak and Akyol 12 claimed that oral valacyclovir is equivalent in efficacy in treating HSV keratitis to topical acyclovir ointment (3%). The HEDS group 8 found that the use of oral acyclovir provided no additional benefit to topical steroids and a topical anti-viral (trifluridine) in the treatment of HSV stromal keratitis.…”

Herpes simplex virus keratitis: an update of the pathogenesis and current treatment with oral and topical antiviral agents

“…Sozen et al in 2006 conducted a study of 28 patients with epithelial HSVK . He noted that patients treated with valacyclovir (1 g twice a day) instead of ACV ointment (five times a day) healed faster …”