Ocena skuteczności gancyklowiru w leczeniu pacjentów z wirusowymi zapaleniami rogówek
Gancyclovir Efficacy Assessment in the Viral Keratitis Treatment
Ewa Mrukwa-Kominek1,2, Łukasz Drzyzga2, Rafał Leszczyński2, Wanda Romaniuk1,2
1 Klinika Okulistyki Katedry Okulistyki Śląskiego Uniwersytetu Medycznego w Katowicach
2 Samodzielny Publiczny Szpital Kliniczny nr 5 Śląskiego Uniwersytetu Medycznego w Katowicach
Kierownik: prof. dr hab. n. med. Wanda Romaniuk
Summary: Purpose: Evaluation of the therapeutic efficiency of ganciclovir 0.15% ophthalmic gel (Virgan) in patients with adenoviral and herpes simplex keratitis.
Material and Methods: Ganciclovir 0.15% ophthalmic gel (Virgan, Laboratoires Thea, France) was applied to 30 patients (48 eyes) with viral keratitis, of whom 38 eyes had adenoviral infection, and 10 eyes had herpes simplex keratitis. The patients were followed-up for over 12 months.
Results: In the group with adenoviral keratitis mean best-corrected visual acuity (BCVA) was 0.2 before treatment, 0.7 on 3rd month, and 0.75 on 12th month. 32 eyes with adenoviral keratitis showed no corneal clouding: in 5 eyes slight subepithelial clouding was observed, and in 1 eye slight peripheral vessel ingrowth was noticed. No significant change in intraocular pressure was observed.
In the group with herpes simplex keratitis mean BCVA was 0.3 before treatment; 0.5 on 3rd month, and 0.6 on 12th month. Complete recovery and no symptoms recurrence during the observation period was found in 6 eyes with recent herpes simplex infection. Three eyes with metaherpetic inflammation demonstrated remission of complaints, epithelialization of corneal changes, and no recurrence during the follow-up period. A vascularized scar developed in 1 eye. Intraocular pressure remained stable in 8, and increased in 2 eyes.
Topical therapy with ganciclovir 0.15% ophthalmic gel was associated with generally good tolerance and rare side-effects.
Conclusions: Ganciclovir 0.15% ophthalmic gel is effective in preventing subepithelial clouding and alleviating clinical symptoms in adenoviral and herpes simplex keratitis.
Słowa kluczowe: gancyklowir, zapalenie herpetyczne rogówki, zapalenie epidemiczne spojówek i rogówki.
Keywords: ganciclovir, herpes simplex keratitis, epidemic keratoconjunctivitis.