摘要:

We have studied certain aspects of the natural history of acute herpes zoster ophthalmicus in placebo-treated patients followed prospectively over one year as part of a therapeutic drug trial. Observations on the incidence of ocular complications relating to the efficacy of oral acyclovir in this disease have been previously published (1,2). This report provides supplemental observations on the natural history of frequently observed ocular complications of zoster ophthalmicus: corneal hypesthesia, episcleritis, dendritiform keratopathy, stromal keratitis, anterior uveitis, and post herpetic neuralgia. These ocular complications of zoster typically present within the first two weeks of the diagnosis. This report characterizes the onset of corneal hypesthesia, episcleritis, dendritiform keratopathy, stromal keratitis, and anterior uveitis as well as interrelationships amongst these sequellae of herpes zoster ophthalmicus. Post-herpetic neuralgia occurs in 52% of patients and persists beyond a year in 22% of those affected.

ISSN:0271-3683    

DOI:10.3109/02713688709020090

出版商:Taylor&Francis    

年代:1987

数据来源: Taylor

摘要:

Varicella zoster was isolated from the vitreous of a patient with the acute retinal necrosis (ARN) syndrome. We utilized a plaque reduction assay to determine the in vitro susceptibility of the ARN isolate to 6 antiviral drugs. The effective doses for 50% inhibition of plaque numbers were 5.3 uM for acyclovir, 4.7 uM for DHPG, 8.7 uM for Ara-A, 100.7 uM for phosphonoacetic acid, 0.07 uH for BVdU and 2.4 uM for IUdR. Similar inhibitory values were obtained for the OKA vaccine strain of varicella zoster virus. These data do not support the notion that the ARN strain may represent a mutant of varicella zoster virus with significant alterations in either the viral thymidase kinase or DNA polymerase genes based upon its antiviral sensitivities. The implications of these results regarding the role of antiviral chemotherapy in the ARN syndrome are discussed.

ISSN:0271-3683    

DOI:10.3109/02713688709020091

出版商:Taylor&Francis    

年代:1987

数据来源: Taylor

摘要:

Acanthamoebais a free-living, fresh-water protozoan that can cause severe corneal disease.Acanthamoebakeratitis can closely mimic epithelial and stromal Herpes simplex keratitis. Three cases of severe keratitis, with a clinical diagnosis of Herpes simplex keratitis, were referred for treatment. One patient presented with a pseudodendritic epithelial lesion that gradually progressed to stromal involvement. A second patient presented with central stromal infiltrate and necrosis, while a third exhibited features of a disciform lesion with the later development of an immune ring.Acanthamoebawas recovered from the cornea in each case. The distinctive characteristics of the history and clinical findings inAcanthamoebakeratitis can aid the clinician in distinguishing between these two clinical entities. Cytopathology and special staining and culture techniques can confirm the diagnosis.

ISSN:0271-3683    

DOI:10.3109/02713688709020092

出版商:Taylor&Francis    

年代:1987

数据来源: Taylor

摘要:

The following paper is intendeo to review those nucleoside analogs currently licensed for the treatment of herpetic diseases. Potentially efficacious congeners also will be considered. The mechanism of action, preclinical and clinical efficacy, and the problems associated with the use of each nucleoside analog will be described.

ISSN:0271-3683    

DOI:10.3109/02713688709020093

出版商:Taylor&Francis    

年代:1987

数据来源: Taylor

摘要:

A double-blind comparative trial of acyclovir (ACV) and adenine arabinoside (ARA-A) in combination with dilute betamethasone was carried out in 30 patients with herpetic disciform keratitis. Of those receiving ACV and betamethasone, 86.7% healed in a mean time of 22.5 days, while 76.9% of those receiving the Ara-A combination healed in a mean time of 26.7 days. There was no statistical difference between the two treatment groups for efficacy parameters. However, the proportion of patients developing superficial punctate keratopathy (SPK) was significantly greater in the Ara-A treatment group.

ISSN:0271-3683    

DOI:10.3109/02713688709020094

出版商:Taylor&Francis    

年代:1987

数据来源: Taylor

摘要:

31 consecutive patients with laboratory proven epithelial herpetic keratitis were included in a prospective, controlled study evaluating combined blunt spatula debridement and trifluridine therapy versus trifluridine alone. A group of 20 patients treated by the combined method was compared in sequence with a group of 11 patients treated by trifluridine alone. Epithelial healing time was significantly shorter in the combined treatment group and treatment failures were less frequent. Blunt spatula debridement was well tolerated. Our findings tend to support the concept that comuined treatment of herpetic epithelial keratitis by debridement and antiviral therapy is beneficial by shortening the course of epithelial lesions.

ISSN:0271-3683    

DOI:10.3109/02713688709020095

出版商:Taylor&Francis    

年代:1987

数据来源: Taylor

摘要:

Twenty nine published clinical trials with acyclovir (ACV) ophthalmic ointment in the treatment of herpes simplex virus (HSV) corneal disease have been reviewed in which ACV has been demonstrated to be effective in the treatment of simple dendritic ulcers, geographic ulcers, deep corneal HSV infections and ocular disease associated with herpes zoster (VZV) infection affecting the ophthalmic division of the trigeminal nerve. 998 patients were studied. The most commonly occurring adverse reactions were superficial punctate keratopathy (in 9. 8% of patients) and burning or stinging on application of the ointment (4%).ACV ophthalmic ointment was first licensed for the treatment of HSV infections of the eye in September 1981. Spontaneous reports of adverse reactions to ACV ophthalmic ointment to both the UK Committee on Safety of Medicines and the Wellcome Group Adverse Reactions Reporting Centre total 43 cases. These include conjunctivitis, inflammation and pain in the treated eye. In this time it is estimated that there have been approximately one million exposures to the ointment. Thus in general use, tolerance to ACV treatment has been extremely good, and clinical trial data demonstrate that it compares favourably with alternative therapies for HSV corneal disease.

ISSN:0271-3683    

DOI:10.3109/02713688709020096

出版商:Taylor&Francis    

年代:1987

数据来源: Taylor

摘要:

Various side effects due to anti-herpetic drugs observed in the last ten years in our department were studied. A total of 132 patients were treated with 5-iodo-2′-deoxyuridine(IDU), 69 with trifluorothymidine(F T), 58 with acyclovir (ACV) and 33 with adenine arabinoside (ara-A). Patch tests were routinely done when patients exhibited contact dermatitis. Of the patients treated with IDU, 3(2.3%) showed contact dermatitis, 2(1.5%) follicular conjunctivitis and 1(0.8%) punctate keratopathy. Of the patients treated with F3T, 7(10. 1%) exhibited contact dermatitis and 1(1.4%) follicular conjunctivitis. In the group treated with ACV, 2(3.4%) patients showed punctate keratopathy. The patients who received ara-A did not show any side effects. We found that FT caused contact dermatitis more frequently in Japanese people than Europeans. These side effects were resolved by switching to another anti-herpetic drug without the occurence of cross-allergy. Therefore, switching to another drug is strongly recommended when patients exhibit side effects in the treatment of herpetic keratitis. Other complications were allergy to atropine and to drug preservative.

ISSN:0271-3683    

DOI:10.3109/02713688709020097

出版商:Taylor&Francis    

年代:1987

数据来源: Taylor

摘要:

The anti-herpes simplex virus (HSV) effect and cytotoxicity of a new nucleoside analogue, 9-(1,3-dihydroxy-2-propoxymethyl)guanine(DHPG) in rabbit cornea were studied. In tests of the anti-HSV effect of DHPG, even 0.03% ointment, given 5 times per day for 2 days, prevented lesion formation. The preventive effect of DHPG was much stronger than that of acyclovir(ACV) or 5-iodo-2′-deoxyuridine(IDU). In tests on the therapeutic effect of DHPG against dendritic ulcers, 0.3% ointment, given 5 times per day for 4 days, had a dramatic therapeutic effect. The effect was stronger than that of 3% ACV or 0.5% IDU ointment. Application of 0.3%, 1% or 3% DHPG ointment to normal rabbit corneas, 5 times per day for 2 weeks resulted in no histopathological abnormalities. The above results show that DHPG is superior to ACV or IDU for treatment of HSV infections.

ISSN:0271-3683    

DOI:10.3109/02713688709020098

出版商:Taylor&Francis    

年代:1987

数据来源: Taylor

摘要:

The present study examined the antiherpetic effect of 2′-nor-cGMP, a new cyclic phosphate derivative of 2′NDG,in vitroand in the mouse keratitis model. The 50% inhibitory dose (ID50) was determined with HSV-1 RE strain in Vero cell monolayers for 2′-nor-cGMP (6.9 mcg. /ml), 2′NDG (.06 mcg/ml), and trifluridine (F3T) (.72 mcg/ml). Balb C mice underwent bilateral ocular inoculation with HSV-1 RE strain, and then were treated with different therapeutic regimens. The antiviral efficacy of each drug was evaluated by ocular virus titers, clinical grading of epithelial keratitis, and histological evaluation of stromal keratitis. 2′-nor-cGMP was the most effective drug (P=. 0001) in reducing ocular viral titers. Both 2′-nor-cGMP and 2′NDG were significantly more effective (P=.000D than F3T in reducing epithelial keratitis, and as effective as F3T in reducing stromal keratitis.

ISSN:0271-3683    

DOI:10.3109/02713688709020099

出版商:Taylor&Francis    

年代:1987

数据来源: Taylor