[Treatment of superficial herpes simplex keratitis with vidarabine (Vira A): multicenter study of 100 cases].
The efficacy of 3% Ara-A ophthalmic ointment (Vira A) has been evaluated on 100 epithelial herpetic keratitis; the poor intra-ocular penetration of Ara-A explains the exclusion of stromal keratitis and kerato-unveitis. Patients were treated 5 times a day until complete epithelial healing of ulcers, then twice a day during 7 days. Healing was obtained within 10.6 days for 87% of the patients, who have been treated by Ara-A at first (n = 77) or after failure of IDU or of IDC (n = 23). The healing rate was higher for the 52 first ocular episodes (92%) than for the 48 recurrences (81%); it decreases to 77% for recurrences after failure of IDU or IDC. Geographic ulcers heal in 76% of cases only. Their length has no influence on their healing. The longest healing time, 10.6 days, can be explained by the long period of time before beginning to apply Ara-A, 12.8 days: significative correlation between both periods of time is highlighted and shows the advantage of an early treatment. The need for a local corticotherapy (n = 8) does not hinder healing in 15.5 days. Two weeks after discontinuation of the treatment, 3 patients presented a relapse, sensitive to a 2nd Ara-A course; a maintenance treatment, superior to 7 days, is necessary. Tolerance to Vira A ointment is good. Indications of Ara-A during ocular herpes are superficial keratitis, especially those resistant to IDU or, from experimental data, to ACV, and their prevention by a possible long term treatment.
Denis
J
J
Service d'Ophtalmologie, Hôtel-Dieu, Paris.
Chouraqui
P
P
Karpouzas
I
I
Hoang-Xuan
T
T
Pouliquen
Y
Y
D000328:Adult; D000998:Antiviral Agents; D001972:Bromodeoxycytidine / Q000031:analogs & derivatives; D003320:Corneal Ulcer / Q000188:drug therapy / Q000209:etiology; D003841:Deoxycytidine / Q000031:analogs & derivatives; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007065:Idoxuridine; D007635:Keratitis, Dendritic / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009824:Ointments; D012008:Recurrence; D014740:Vidarabine / Q000627:therapeutic use*
D000998:Antiviral Agents; D009824:Ointments; D003841:Deoxycytidine; D001972:Bromodeoxycytidine; C011288:ibacitabine; D014740:Vidarabine; D007065:Idoxuridine
Traitement des kératites herpétiques superficielles par la vidarabine (Vira A): étude multicentrique de 100 cas.