Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifteen cases of herpes simplex epithelial keratitis, which failed to heal following IDU therapy, were treated with Ara-A 3% ointment applied fives times daily. Epithelial disease resolved in fourteen cases with Ara-A and mean healing time was 6,6 days. No sign of ocular or adnexal toxicity were noted.
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PMID:[Adenine-arabinoside in the treatment of idu-resistant herpes simplex keratitis (author's transl)]. 15 54

In 20 cases of herpes simplex keratitis the efficacy of Vidarabin ointment has been tested, in 19 cases after corneal abrasion. The eyes were treated once a day and padded until the epithelial defects had closed. Thereafter the ointment was applied 4 times per day for about one week more. On the average epithelial closure had been achieved after 2.4 days, complete normalization of the epithelium after a total of 3.6 days. This therapy results in a considerable shortening of the healing process as compared to the topical use of anti-viral medication alone. From this aspect Vidarabin ointment has proved to be a valuable adjuvant.
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PMID:[Treatment of herpes simplex keratitis with Vidarabin ointment (author's transl)]. 34 60

Idoxuridine which was first used in 1960 (Kaufman et al., 1962), has been for many years the only antiviral agent available in the treatment of herpetic keratitis. It is however no more successful than is mechanical removal of diseased epithelium (Patterson & Jones, 1967), and furthermore it may give rise to serious toxic side effects. The search for an alternative medication is therefore a pressing one. Trifluorothymidine (F3T) has, in recent years, been shown to be more effective than IDU and to be free from significant toxicity. Both of these drugs are pyrimidine nucleosides. Adenine Arabinoside or Arabinoside-A (Ara-A) is, by contrast, a purine nucleoside. It is thought to exert its antiviral effect by blocking DNA polymerase and ribonucleotide reductase.
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PMID:Treatment of herpetic keratitis. 41 44

Large scale, multiclinic evaluations of vidarabine (Ara-A, Vira A, adenine arabinoside) for treating herpetic keratitis have been conducted as double-blind studies (169 patients) in comparison with IDU and open studies (146 patients). In the open studies, the disease in the majority of patients had been refractory to IDU. The effects of vidarabine and IDU were approximately the same in improvement of symptoms (lacrimination, photophobia, sensitivity) and percent of and time for corneal reepithelialization. With vidarabine, significantly more patients had improved distant visual acuity than did with IDU. In the open studies, vidarabine also was effective. Of 116 patients whose ulcers had not responded to IDU, 91 (78%) had reepithelialization within four weeks of treatment with vidarabine. On the basis of results from these studies, vidarabine appears to be a safe and effective drug for treating herpes simplex keratitis.
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PMID:Vidarabine therapy of simple and IDU-complicated herpetic keratitis. 79 69

The efficacy of 3% Ara-A ophthalmic ointment (Vira A) has been evaluated on 100 epithelial herpetic keratitis; the poor intra-ocular penetration of Ara-A explains the exclusion of stromal keratitis and kerato-unveitis. Patients were treated 5 times a day until complete epithelial healing of ulcers, then twice a day during 7 days. Healing was obtained within 10.6 days for 87% of the patients, who have been treated by Ara-A at first (n = 77) or after failure of IDU or of IDC (n = 23). The healing rate was higher for the 52 first ocular episodes (92%) than for the 48 recurrences (81%); it decreases to 77% for recurrences after failure of IDU or IDC. Geographic ulcers heal in 76% of cases only. Their length has no influence on their healing. The longest healing time, 10.6 days, can be explained by the long period of time before beginning to apply Ara-A, 12.8 days: significative correlation between both periods of time is highlighted and shows the advantage of an early treatment. The need for a local corticotherapy (n = 8) does not hinder healing in 15.5 days. Two weeks after discontinuation of the treatment, 3 patients presented a relapse, sensitive to a 2nd Ara-A course; a maintenance treatment, superior to 7 days, is necessary. Tolerance to Vira A ointment is good. Indications of Ara-A during ocular herpes are superficial keratitis, especially those resistant to IDU or, from experimental data, to ACV, and their prevention by a possible long term treatment.
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PMID:[Treatment of superficial herpes simplex keratitis with vidarabine (Vira A): multicenter study of 100 cases]. 222 99

The present paper reviews the adverse side effects caused by topically applied antiviral agents in herpetic keratitis. The effective treatment of herpetic keratitis with IDU, a chemotherapeutic agent, was first reported in 1962. After its introduction into ophthalmic therapy for herpetic keratitis, drops of IDU were administered every hour by day combined with ointment every two hours by night. The therapy often continued for months or in some cases, even more than one year. Numerous reports on its side effects have appeared. The side effects can be classified into two categories. The first category is allergic contact blepharodermatitis, a type IV delayed hypersensitivity reaction. Its occurrence is difficult to foresee. This category I side effect rarely results in the destruction of the ocular tissues. The second category of side effects is a drug-induced toxic side effect resulting in punctate epithelial keratitis, papillary conjunctivitis or follicular hypertrophy and lacrimal punctal obstruction. After withdrawal of IDU, these ill effects usually subside soon. When IDU is further continued, the destructive change of the tissues will ensue. Conjunctival cicatrization, symblepharon, corneal neovascularization, cicatrization and irreversible punctal occlusion have been reported in cases with prolonged IDU treatment. In addition to IDU for therapy of herpetic keratitis, we are fortunate to have F3T, Ara-A and acyclovir. They show no cross sensitivity reaction nor any cross toxic reaction to each other. However, if administered more than several times daily and continued for a prolonged period of time, these antiviral agents, like IDU, can also result in reversible side effects and, further, irreversible tissue destruction. Conjunctival cicatrization and permanent punctal occlusion caused by prolonged administration of F3T have been reported. Prompt recognition of the untoward reactions and withdrawal of the antiviral agent will result in the subsidence of the toxic reaction changes and prevent the eye from irreversible destruction. The recognition, prevention and management of the untoward side effects also are discussed.
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PMID:[Adverse side effects caused by topically applied antiviral agents in herpetic keratitis]. 248 Apr 57

(E)-5-(2-Bromovinyl)-2'-deoxyuridine (1; BrVUdR) inhibits the replication of herpes simplex virus type 1 (HSV-1) and of varicella-zoster virus (VZV) in vitro at concentrations of 0.01 to 0.23 mumol/l, whereas herpes simplex virus type 2 (HSV-2) is influenced only at 5.5 to 27 mumol/l. In comparison to some classical and newly developed antiherpetics, i. e. 5-iodo-2'-desoxyuridine (2; idoxuridine, IDU), 9-beta-D-arabinofuranosyladenine (4; vidarabine Ara-A), 9-(2-hydroxyethoxymethyl) guanine (5; acyclovir, ACV) and 2'-fluoro-5-iodo-1-beta-D-aracytosine (6;FIAC) the following order of decreasing activity was found:1 greater than 6 greater than 5 greater than 2 greater than 4 (against HSV-1) and 6 greater than 2 greater than 5 greater than 1 greater than 4 (against HSV-2). The high selectivity of the antiviral effect of BrVUdR towards HSV-1 and TZV is based on the fact, that proliferation of different mammalian cell lines is inhibited by 50% only at concentrations as high as 90 to 170 mumol/l, resulting in a therapeutical index of 1000 to 10,000. Successful treatment of an HSV-1 encephalitis in mice as well as an HSV-1 keratitis of rabbits confirmed the efficiency of 1 in experimental animal infections. No toxic side effects in both local and systemic applications were observed. Promising data from cell culture and animal experiments recommend 1 as a potential candidate for the local and systemic treatment of HSV-1 and VZV infections in man.
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PMID:[(E)-5-(2-bromovinyl)-2'-desoxyuridine--a new nucleoside analog with selective inhibitory action against herpesviruses. Studies in cell culture and animal experiments]. 282 99

A double-blind comparative trial of acyclovir (ACV) and adenine arabinoside (ARA-A) in combination with dilute betamethasone was carried out in 30 patients with herpetic disciform keratitis. Of those receiving ACV and betamethasone, 86.7% healed in a mean time of 22.5 days, while 76.9% of those receiving the Ara-A combination healed in a mean time of 26.7 days. There was no statistical difference between the two treatment groups for efficacy parameters. However, the proportion of patients developing superficial punctate keratopathy (SPK) was significantly greater in the Ara-A treatment group.
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PMID:A double-blind comparative trial of acyclovir and adenine arabinoside in combination with dilute betamethasone in the management of herpetic disciform keratitis. 354 62

Clinical resistance of herpetic keratitis to antiviral agents constitutes one of the reasons for failure of treatment after their administration. A retrospective study of 42 cases of superficial herpetic keratitis resistant to IDU, IDU and IDC, and Ara-A demonstrated that in 2 out of 3 cases this resistance appeared in patients previously treated locally with antiviral compounds for anterior ocular lesions. Patients resistant to IDU were then treated with Ara-A, and those not responding to Ara-A, with TFT. Resistance may be observed following this new treatment during the subsequent relapses.
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PMID:[Clinical resistance of herpetic keratitis to antiviral agents (author's transl)]. 626 Aug 50

The clinical value of five synthetic antiherpetic nucleosides is discussed: iododeoxyuridine (IDU), adenine-arabinoside (Ara-A), trifluorothymidine (TFT), acyclovir (ACV), and bromovinyldeoxyuridine (BVDU). Depending on the type of herpes simplex virus eye disease, either TFT or ACV are currently the drugs of choice. For BVDU, further controlled studies have to be awaited. For the special situation of superficial herpetic keratitis (dendritic keratitis), a combination therapy with either TFT or ACV plus interferon has proven to be significantly better than a monotherapy with only nucleosides.
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PMID:Use of nucleoside analogues in the treatment of herpes simplex virus eye diseases. 668 78


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