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MP Karavellas, N Markomichelakis, P Zafirakis, A Kouris; Long-Term Oral Acyclovir for the Prevention of Recurrent Herpetic Uveitis . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4311.
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Purpose: To evaluate the efficacy and safety of long-term oral acyclovir prophylaxis in reducing the rate of recurrence of herpetic uveitis. Methods: Patients with HSV or VZV uveitis were initially treated with oral acyclovir, 800mg 3 times daily and topical steroids, until resolution of inflammation, followed by prophylactic oral acyclovir, 800mg daily.The rates of recurrence of uveitis per patient per year following initiation of prophylactic oral acyclovir were compared with those prior to initiation of prophylaxis. Patients were also evaluated for adverse effects of acyclovir treatment. Results: Thirty-one patients aged 29 to 77 were followed for 8 to 56 months while receiving oral acyclovir prophylaxis. Of the 31 patients, 27 had HSV, and 4 VZV-associated uveitis/keratouveitis.Duration of uveitis prior to initiation of acyclovir prophylaxis ranged from 0.5 months to 30 year (mean 7.83 years, median 5 years).The number of recurrences of herpetic uveitis prior to prophylaxis ranged from 1 to 15 recurrences /patient (0.44/pt/yr).Following initiation of acyclovir, 10 of 31 patients (32%) developed 1 to 2 recurrences during follow-up, while 21 patients (68%) remained free of recurrence.The mean number of recurrences was 0.36/pt/yr, and was statistically significantly lower than that prior to prophylaxis (p=0.001, paired t-test).Acyclovir was well tolerated. Conclusion: Long-term supressive oral acyclovir therapy was associated with a reduced rate of recurrent herpetic uveitis in this patient population, and was well tolerated.
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