Treating Herpes Simplex Viral Keratitis: What Are the Options?

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Current therapeutic practice is based on outcomes from the Herpetic Eye Disease Studies I and II
Current therapeutic practice is based on outcomes from the Herpetic Eye Disease Studies I and II

(HealthDay News) — There is a need for development of new anti-herpetic compounds with different mechanisms of action for herpes simplex viral keratitis (HSVK), according to a review published online June 6 in Clinical & Experimental Ophthalmology.

Noting that HSVK is an important cause of visual impairment, Michael Tsatsos, M.D., Ph.D., from the Dorset County Hospital NHS Foundation Trust in Dorchester, U.K., and colleagues reviewed the evidence on the pathogenesis of different HSVK disease modalities.

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The researchers note that current therapeutic practice is based on outcomes from the Herpetic Eye Disease Studies I and II, which examined the effectiveness of oral acyclovir in management of stromal herpes keratitis. Newer medications such as valacyclovir may have a superior therapeutic effect to acyclovir; the reduced dosage may aid compliance, and increased bioavailability could increase efficacy. With the increased incidence of acyclovir-resistant infections, there is a need to develop new anti-herpetic compounds with different mechanisms of action, which will be safe and effective against viral strains that are drug resistant; antiviral agents such as foscarnet and cidofovir may be used. Topical ganciclovir is a front-line topical antiviral drug which exhibits less toxicity and offers a simpler dosing regimen.

"Furthering the understanding of herpetic eye disease and promoting the development of more targeted therapy will undoubtedly alter our practice in the future and reduce the significant disease burden associated with this condition," the authors write.

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