title: Herpetic stromal disease: response to acyclovir/steroid therapy.
abstract: The efficacy of combined acyclovir and steroid therapy in the treatment of herpetic stromal disease was evaluated by clinical evaluation of disease, the rebound of disease following termination of therapy, and the recovery of virus and viral DNA from corneas in a rabbit model. Therapy with acyclovir alone produced a significant reduction in corneal thickness in 10% of eyes. Addition of steroid to acyclovir therapy decreased the severity of stromal disease as measured by corneal thickness and increased the frequency of response to treatment to 63% of eyes. All eyes receiving acyclovir alone experienced rebound of disease following termination of therapy. Combined therapy increased the severity of rebound of corneal disease. Virus was recovered from cell cultures established after recovery from rebound in 50% of untreated and treated eyes. Viral DNA was detected by PCR in five of the nine corneal cultures which did not produce infectious virus.
authors.affiliation: Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, USA.
authors.forename: W J
authors.initials: WJ
authors.lastname: O'Brien
authors.forename: A P
authors.initials: AP
authors.lastname: Segundo
authors.forename: J
authors.initials: J
authors.lastname: Guy
authors.forename: E M
authors.initials: EM
authors.lastname: Dorn
authors.forename: J L
authors.initials: JL
authors.lastname: Taylor
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use*; D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use*; D003319:Corneal Stroma / Q000473:pathology / Q000821:virology*; D004279:DNA, Viral / Q000032:analysis; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use*; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000302:isolation & purification; D016849:Keratitis, Herpetic / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D009883:Ophthalmic Solutions; D016133:Polymerase Chain Reaction; D011239:Prednisolone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011817:Rabbits; D011897:Random Allocation; D012008:Recurrence; D012668:Trigeminal Ganglion / Q000821:virology; D014775:Virus Activation / Q000187:drug effects; D017201:Virus Shedding / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D005938:Glucocorticoids; D009883:Ophthalmic Solutions; C009935:prednisolone acetate; D011239:Prednisolone; D000212:Acyclovir