Oral valganciclovir treatment of varicella zoster virus acute retinal necrosis

Abstract

We describe a case of varicella zoster virus acute retinal necrosis (ARN) in an immunocompetent woman that was successfully treated with oral valganciclovir. We believe this to be the first reported case of the use of oral valganciclovir for ARN.Case report

Acute retinal necrosis in a monocular patient complicated by acyclovir-induced nephrotoxicity

“…19 Other options for the treatment of ARN include ganciclovir and its pro-drug valganciclovir. 20,21 In general, these agents are preserved for the treatment of CMV-related ARN and as an alternative to standard therapy, as in the case we described.…”

Akute Retinanekrose

“…Es ist 10-bis 15-fach wirksamer gegen CMV und EBV als Aciclovir, dafür aber schlechter wirksam gegen HSV und VZV [9,14]. Da mutagene, karzinogene, fraglich teratogene und hä-matotoxische Wirkungen (Neutropenie, Anämie) sowie Diarrhç-en auftreten kçnnen, muss eine strenge Indikationsstellung erfolgen [33,36].…”

“…zur Verfügung. Alle drei Präparate sind orale Prodrugs, durch die aufgrund einer hohen Plasma-Bioaviabilität schnelle intravitreale Konzentrationen, vergleichbar mit einer intravençsen Aciclovirtherapie, erreicht werden [37,38].…”

Antiviral selection in the management of acute retinal necrosis

“…Oral acyclovir 400 mg three times daily was continued for 3 months. 61 In another report, Cottet et al treated a case of HSV-2 ARN with intravenous acyclovir 10 mg/kg 3 times daily for 4 weeks, oral valganciclovir 450 mg twice daily for 2 weeks and a single intravitreal injection of ganciclovir 2000 µg. Oral acyclovir was continued for 3 months.…”