Sarah Goodwin

Kathi Ovnic
Holly Korschun
July 30, 1998

Emory Eye Center is the Coordinating Center in Southeast or NIH-funded Study

ATLANTA -- Twelve months of treatment with acyclovir reduces the rate of recurrent herpes simplex virus (HSV) disease of the eye, report Emory Eye Center researchers and others in a multi-center study published in this week's New England Journal of Medicine.

Ocular infection from HSV affects nearly 50,000 Americans each year and is a leading cause of vision loss. Acyclovir, taken orally, has long been used to control genital herpes. During a four-year, national clinical trial supported by the National Eye Institute, researchers found that oral acyclovir also benefits patients who have recurrent ocular herpes.

"Recurrence is a significant problem for these patients," says cornea specialist R. Doyle Stulting, M.D., Ph.D., principal investigator of the Emory component of the national Herpetic Eye Disease Study. "The most severe form of ocular herpes ­ stromal keratitis -- can lead to vision loss from corneal scarring and from secondary disorders such as glaucoma and cataract."

Recurrent stromal keratitis often can result in the need for a corneal transplant. Of 703 patients followed in the study, 357 patients were randomly assigned to receive 400 mg of acyclovir twice daily for 12 months and 346 received a placebo. All patients were followed for 12 months and observed for six more months. Researchers found that 32 percent of subjects in the placebo group had a recurrence of ocular herpes compared with 19 percent of subjects in the acyclovir group. These findings indicate there is a significant reduction by 41 percent between the two groups.

For patients who had a previous history of stromal keratitis, acyclovir reduced the rate of recurrence from 28 percent to 14 percent.

"While there is no cure for HSV, acyclovir is the best line of defense against recurrent ocular infections, especially stromal keratitis," Dr. Stulting says.

Less severe forms of ocular herpes include conjunctivitis, epithelial keratitis and blepharitis.

Side-effects from acyclovir were rare; only five patients in the study stopped taking the medication because of side-effects. However, patients with ocular herpes should discuss the benefits and risks of taking acyclovir long-term with their ophthalmologists, according to Dr. Stulting.

The Emory Eye Center was the major patient-recruiting site for the National Eye Institute-sponsored Herpetic Eye Disease Study, and helped coordinate results from 10 other sites in the Southeast.

Emory Eye Center cornea specialists treat problems caused by disease, Genetic predisposition, injury or aging, including cataract, ocular herpes, keratoconus, corneal abrasions, and other conditions that affect the outer layers of the eye. Emory's cornea section is also a national leader in the field of refractive surgery, offering the latest laser treatments to correct nearsightedness, farsightedness and astigmatism.

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