HERPES ZOSTER OPHTHALMICUS – ACUTE OCULAR MANIFESTATIONS AND ROLE OF ORAL ACYCLOVIR

Herpes Zoster Ophthalmicus

Abstract

Objective: To determine the frequency and severity of acute ocular complications in patients of Herpes Zoster Ophthalmicus (HZO) and to evaluate the role of oral Acyclovir in the treatment of HZO.
Study Design: A quasi-experimental study.
Place and Duration of Study: The study was conducted at eye department of CMH Pano Aqil and CMH Peshawar from Jan 2004 to Jun 2006.
Patients and Methods: Thirty Seven patients of HZO were prospectively evaluated for protocol defined ocular manifestations of HZO. Frequency and duration of acute ocular manifestations were analyzed and compared in between those patients who received oral acyclovir within 72 hours of rash onset (Group A, n = 19) and those who received it after 72 hours of rash onset (Group B, n = 18).
Results: The most frequent acute ocular manifestations were conjunctivitis (63% in Gp A; 50% in Gp B), acute epithelial keratitis (37% in Gp A; 39% in Gp B), and anterior uveitis (11% in Gp A; 39% in Gp B). In between group difference in the frequencies of various ocular complications was not statistically significant. However, incidence of overall keratitis, anterior uveitis and glaucoma was more in group B. Moreover, mean duration of acute ocular signs was longer in group B.
Conclusion: The results suggested that early initiation of oral acyclovir treatment (within 72 hours of rash onset) has a beneficial role in limiting the frequency and duration of acute ocular complications of HZO.