title: Valacyclovir in the treatment of acute retinal necrosis.
abstract: BACKGROUND
  To report the outcome of oral valacyclovir as the sole antiviral therapy for patients with acute retinal necrosis (ARN).
  
  
  METHODS
  This study reports a retrospective, interventional case series of nine consecutive patients with ten eyes with newly diagnosed ARN treated with oral valacyclovir as the sole antiviral agent. Eight patients received oral valacyclovir 2 g tid (Valtrex, GlaxoSmithKline) and one patient with impaired renal function received oral 1 g tid. The main outcome measures were response to treatment, time to initial response to treatment, time to complete resolution of retinitis, best corrected visual acuity (BCVA) at final follow-up, retinal detachment and development of recurrent or second eye disease.
  
  
  RESULTS
  Retinitis resolved in ten of ten (100%) affected eyes. The median time to initial detectable response was seven days and the median time to complete resolution was 21 days. A final BCVA of 20/40 or better was achieved in 6/10 (60%) of eyes. 3/10 eyes (30%) developed a retinal detachment. No patients developed either disease reactivation or second eye involvement over the course of the study (mean follow up 31 weeks, range 7 to 104 weeks).
  
  
  CONCLUSIONS
  Treatment with oral valacyclovir as the sole antiviral therapy resulted in complete resolution of retinitis. Final BCVA and retinal detachment rate were comparable with previously reported outcomes for intravenous acyclovir.
authors.affiliation: Division of Immunology & Inflammation, Faculty of Medicine, Imperial College London, London, UK. s.r.taylor@imperial.ac.uk
authors.forename: Simon Rj
authors.initials: SR
authors.lastname: Taylor
authors.forename: Robin
authors.initials: R
authors.lastname: Hamilton
authors.forename: Claire Y
authors.initials: CY
authors.lastname: Hooper
authors.forename: Lavnish
authors.initials: L
authors.lastname: Joshi
authors.forename: Jiten
authors.initials: J
authors.lastname: Morarji
authors.forename: Nitin
authors.initials: N
authors.lastname: Gupta
authors.forename: Sue L
authors.initials: SL
authors.lastname: Lightman
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011355:Prodrugs; D015882:Retinal Necrosis Syndrome, Acute / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D000077483:Valacyclovir; D014633:Valine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D014792:Visual Acuity
chemical_list: D000998:Antiviral Agents; D011355:Prodrugs; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir