title: Acute Herpetic Keratitis: What is the Role for Ganciclovir Ophthalmic Gel?
abstract: Herpes simplex keratitis (HSK) is a major cause of corneal blindness in the world. Following the primary infection, the virus enters into a latent phase. Recurrent infectious or immune keratitis cause structural damage to the cornea, scarring, and may lead to blindness. Several commercially available topical and oral antiviral drugs for HSK are currently available. However, toxicity and low patient compliance hamper their use in HSK. Further, oral antiviral drugs alone are not always effective in HSK. Thus, there had been a need for safe and effective topical antiviral agents against HSK. Systemic ganciclovir has been in use for the treatment of cytomegalovirus infections. Recently, topical ganciclovir has become available for use in patients with HSK. Ganciclovir 0.15% ophthalmic gel has been shown to be both safe and effective against viruses of the herpes family. Topical ganciclovir ophthalmic gel is well tolerated and does not cause significant toxic effects on the ocular surface. Several multicenter studies have revealed the potential role of ganciclovir ophthalmic gel in the treatment and prophylaxis of epithelial HSK. In this paper, we have reviewed the pharmacology, efficacy, side effects, and the role of ganciclovir ophthalmic gel 0.15% in the treatment of acute herpetic keratitis.
authors: Ocular Surface Imaging Center, Cornea and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, and Department of Ophthalmology, Harvard Medical School, Boston, MA. ; Eskisehir Osmangazi University Medical School, Department of Ophthalmology, Eskisehir, Turkey.
authors: Afsun
authors: A
authors: Sahin
authors: Pedram
authors: P
authors: Hamrah
keywords: antiviral; ganciclovir; herpes simplex; herpetic; keratitis
references: Clin Ophthalmol. 2010 Apr 26;4:285-99
references: 20463796
references: J Med Chem. 1964 Jan;7:1-5
references: 14186018
references: J Infect Dis. 2008 Sep 1;198(5):659-63
references: 18627246
references: Antiviral Res. 1984 Dec;4(6):333-8
references: 6085232
references: Antivir Chem Chemother. 2001 May;12(3):175-86
references: 12959326
references: Antimicrob Agents Chemother. 1998 Apr;42(4):868-72
references: 9559798
references: Curr Eye Res. 1987 Jan;6(1):237-9
references: 3103984
references: N Engl J Med. 1996 Sep 5;335(10):721-9
references: 8786764
references: J Ocul Pharmacol. 1994 Summer;10(2):439-51
references: 8083563
references: J Pharm Sci. 2002 Mar;91(3):660-8
references: 11920751
references: Clin Ophthalmol. 2007 Dec;1(4):441-53
references: 19668521
references: Rev Med Virol. 2001 Nov-Dec;11(6):381-95
references: 11747000
references: Arch Ophthalmol. 1989 Aug;107(8):1155-9
references: 2787981
references: Drug Resist Updat. 2002 Apr;5(2):88-114
references: 12135584
references: Curr Eye Res. 1984 Aug;3(8):1007-15
references: 6333319
references: Antiviral Res. 1985 Oct;5(5):259-67
references: 2998275
references: AAPS PharmSciTech. 2003;4(3):E45
references: 14621977
references: Trans Am Ophthalmol Soc. 2000;98:505-32
references: 11190039
references: Arch Virol. 1976;51(1-2):1-13
references: 183627
references: Int J Dermatol. 2007 Dec;46(12):1263-6
references: 18173520
references: Doc Ophthalmol. 1981 Mar 20;50(2):287-90
references: 6785059
references: J Med Virol. 1997 Jun;52(2):136-42
references: 9179758
references: Drugs. 1998 Jul;56(1):115-46
references: 9664203
references: Rev Infect Dis. 1988 Jul-Aug;10 Suppl 3:S490-4
references: 2847285
references: Am J Ophthalmol. 1979 Jun;87(6):814-8
references: 110152
references: J Ocul Pharmacol Ther. 2005 Dec;21(6):463-74
references: 16386088
references: DICP. 1989 Jan;23(1):5-12
references: 2541566
references: Science. 1964 Aug 7;145(3632):585-6
references: 14163783
references: Antiviral Res. 2006 Sep;71(2-3):154-63
references: 16765457
references: Cornea. 1994 Sep;13(5):435-9
references: 7995068
references: Ophthalmology. 2012 Mar;119(3):588-95
references: 22137552
references: Drugs. 1989 Mar;37(3):233-309
references: 2653790
references: Expert Opin Investig Drugs. 2001 Sep;10(9):1745-53
references: 11772283
references: Br J Ophthalmol. 1982 Aug;66(8):506-8
references: 6809036
references: Drugs. 2001;61(8):1153-83
references: 11465876
references: Curr Eye Res. 2003 Mar-Apr;26(3-4):175-83
references: 12815545
references: Antiviral Res. 1984 Jun;4(3):143-57
references: 6476819
references: Arch Ophthalmol. 2003 Jan;121(1):108-12
references: 12523894
references: Cochrane Database Syst Rev. 2010 Dec 08;(12):CD002898
references: 21154352
references: Acta Ophthalmol (Copenh). 1980;58(1):117-20
references: 6773292
references: AAPS PharmSci. 2003;5(2):E15
references: 12866942
references: Clin Microbiol Rev. 2003 Jan;16(1):114-28
references: 12525428
references: Curr Eye Res. 1991;10 Suppl:111-5
references: 1864087
references: Drugs. 2011 Mar 26;71(5):603-10
references: 21443283
references: Nat New Biol. 1972 Feb 16;235(59):216-7
references: 4334930
references: Cochrane Database Syst Rev. 2008 Jan 23;(1):CD002898
references: 18254009
references: Cornea. 1999 Mar;18(2):127-43
references: 10090358
references: Cornea. 1997 Jul;16(4):393-9
references: 9220235
references: Cornea. 1999 Mar;18(2):144-54
references: 10090359
references: Adv Exp Med Biol. 1996;394:93-103
references: 8815713
references: Invest Ophthalmol. 1964 Oct;3:512-6
references: 14229937
references: Am J Ophthalmol. 2006 Mar;141(3):547-557
references: 16490506
references: Antimicrob Agents Chemother. 2009 Jul;53(7):3017-23
references: 19307355
references: Clin Ophthalmol. 2010 Aug 19;4:905-12
references: 20823931
references: Arch Ophthalmol. 1978 Oct;96(10):1839-41
references: 100084
references: Drugs. 1990 Apr;39(4):597-638
references: 2161731
references: Cornea. 2001 Jan;20(1):1-13
references: 11188989
references: Surv Ophthalmol. 1976 Sep-Oct;21(2):121-35
references: 988644
references: Br J Ophthalmol. 1990 May;74(5):286-8
references: 2162190
references: Antimicrob Agents Chemother. 1983 May;23(5):676-82
references: 6307132
references: Curr Eye Res. 2003 Mar-Apr;26(3-4):151-63
references: 12815543
references: Med Lett Drugs Ther. 1980 May 30;22(11):46-8
references: 6768975
references: Graefes Arch Clin Exp Ophthalmol. 1983;220(1):6-12
references: 6403411
references: Arch Ophthalmol. 1998 Jun;116(6):777-80
references: 9639447
references: Arch Ophthalmol. 1989 Aug;107(8):1160-5
references: 2757546
references: Br J Ophthalmol. 1996 Feb;80(2):140-3
references: 8814744