Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Antiviral therapy found to prevent blindness, other serious effects for patients with eye shingles

11.03.2003


Mayo Clinic has found that for patients with eye shingles, oral antiviral drugs are critical to prevent long-term consequences in the eye. Untreated, 10 percent of eye shingles patients experience a serious long-term outcome, such as severe visual loss, eyelid scarring or chronic in-turning of the eyelashes; if treated, two percent of patients experience these effects. The Mayo Clinic study refutes the findings of a previous British study of oral antivirals in patients with eye shingles.



"This is the first time it’s been documented that within the eye, the chance of something really bad happening is greatly reduced by administering oral antivirals," says Keith Baratz, M.D., Mayo Clinic ophthalmologist and author of the manuscript, "Herpes Zoster Ophthalmicus in Olmsted County, Minnesota: Have Systemic Antivirals Made a Difference?" to be published in the March issue of Archives of Ophthalmology, http://archopht.ama-assn.org.

This study, based on data from the Rochester Epidemiology Project, http://www.mayo.edu/research/mir/topic_1029.html, is the first long-term follow-up study and the second largest study of this medication with patients diagnosed with herpes zoster opthalmicus. The largest study completed of oral antivirals for this disease to date, by Moorfield’s Eye Hospital in London, found that oral antivirals did not significantly affect long-term outcome; the study was not well controlled, however, according to the Mayo Clinic researchers. Oral antiviral treatment has been controversial due to the Moorfield’s study as well as the cost of the medicine, which can cost several hundred dollars for a course of treatment, or approximately $13 to $22 per day.


This study compared 323 cases of eye shingles treated in Olmsted County, Minn., between 1976 and 1998. Of these cases, two-thirds, or 202 patients, were treated with oral antiviral medication, such as acyclovir, famciclovir or valacyclovir; and one-third, or 121, were not treated. In untreated patients, 8.9 percent experienced adverse outcomes five to 10 years following the onset of the illness; 2.1 percent of treated patients experienced such outcomes. Also, the group given oral antivirals was less likely to experience the complication neurotrophic keratitis, or loss of feeling in and inflammation of the cornea. Those treated, however, did experience more frequent conjunctivitis, or inflammation of the eyelid-lining membrane and sclera surface, for reasons unknown to the investigators.

Timing of treatment also affected the long-term outcome. Those who experienced long-term negative outcomes such as glaucoma, scleritis (inflammation of the white coating around the eyeball), uveitis (inflammation of the vascular middle coating of the eye), corneal edema or stromal keratitis had waited an average of 4.8 days before receiving treatment; those who did not experience these outcomes waited an average of 3.8 days prior to treatment.

"A delay in treatment with the drug negatively affected the course of the disease," says Dr. Baratz. "Getting in to your doctor quickly is an issue."

According to Dr. Baratz, receiving timely treatment for eye shingles is complicated, however, by nonspecific symptoms at the start of the disease. The origin of these early symptoms also is difficult to pinpoint.

"You can get headaches first, or a rash first or pinkeye first," says Dr. Baratz. "Very early on it can be difficult to diagnose." He adds, however, that herpes zoster ophthalmicus is very easy to diagnose once the rash starts.

Herpes zoster, or shingles, is a common condition; 20 percent of all those who have had chicken pox will get shingles, and 20 percent of those experience the disease in the eye. People at higher risk for the disease include the elderly, patients taking immunosuppressant drugs or those experiencing high stress. It may strike people of any age. The virus causing the disease, varicella zoster, can remain in the body and lie "dormant," reactivating years later in nerve cells. Factors such as stress, medications, illness and aging may prompt the reactivation.

"You can get chicken pox when you’re three years old, and it can come back when you’re 70," says Dr. Baratz. " Everyone who has shingles has had chicken pox before. Chicken pox usually is not a big deal; shingles is a big deal."

Herpes zoster most commonly occurs in the body’s trunk, but it also may spread along the ophthalmic portion of the fifth cranial nerve, affecting the eye. The symptoms manifest in one eye only, as shingles typically concentrate on one side of the body.

"It is very painful and can destroy your sight," says Dr. Baratz.

Lisa Copeland | EurekAlert!
Further information:
http://www.mayo.edu/research/mir/topic_1029.html

More articles from Health and Medicine:

nachricht Electrical 'switch' in brain's capillary network monitors activity and controls blood flow
27.03.2017 | Larner College of Medicine at the University of Vermont

nachricht Laser activated gold pyramids could deliver drugs, DNA into cells without harm
24.03.2017 | Harvard John A. Paulson School of Engineering and Applied Sciences

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

Im Focus: Researchers Imitate Molecular Crowding in Cells

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Northern oceans pumped CO2 into the atmosphere

27.03.2017 | Earth Sciences

Fingerprint' technique spots frog populations at risk from pollution

27.03.2017 | Life Sciences

Big data approach to predict protein structure

27.03.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>