Herbort C P, Buechi E R, Piguet B, Zografos L, Fitting P
Hopital Ophtalmique Jules Gonin, Department of Ophthalmology, University of Lausanne, Switzerland.
Curr Eye Res. 1991;10 Suppl:171-5. doi: 10.3109/02713689109020375.
Systemic acyclovir (ACV), a new potent anti-herpes drug, was shown to reduce effectively the morbidity in the acute phase of herpes zoster ophthalmicus (AHZO). Using high dose oral ACV (5 X 800 mg/day) our aim in this study was: (1) to compare disease profiles in the ACV-treated group and in a group of zoster patients having had no ACV, analysed retrospectively; (2) to establish if high-dose ACV was able to prevent severe long term complications of AHZO; and (3) to determine the present role of corticosteroids in AHZO. From 1984 to 1988, 48 patients with AHZO of less than 3 days' duration were included. All patients received at least 7 days of oral ACV (5 X 800 mg/d) associated with topical ACV. Steroids were not given unless severe uveitis occurred. Follow-up was 2 years in 43 patients and 1 year in all 48 patients. Main conclusions from our study are: 1. Ocular involvement occurred in 67% of ACV-treated cases, a rate comparable to our retrospective group (59%) and to the literature (71%). However the rate of severe long term complications was minimal (4%) when compared to our non-treated retrospective group (21%). 2. Steroid treatment was not necessary in any of the ACV-treated patients. 3. ACV was well tolerated and did not have to be discontinued in any of the patients. High dose ACV and avoidance of steroids seems to eliminate the severe complications of AHZO.
全身性无环鸟苷（ACV）是一种新型强效抗疱疹药物，已证明它能有效降低眼部带状疱疹急性期（AHZO）的发病率。本研究采用高剂量口服ACV（5×800毫克/天），目的是：（1）回顾性分析比较ACV治疗组和未使用ACV的带状疱疹患者组的疾病情况；（2）确定高剂量ACV是否能够预防AHZO的严重长期并发症；（3）确定皮质类固醇在AHZO中的当前作用。1984年至1988年，纳入了48例病程少于3天的AHZO患者。所有患者均接受至少7天的口服ACV（5×800毫克/天）并联合局部使用ACV。除非发生严重葡萄膜炎，否则不给予类固醇。43例患者随访2年，48例患者全部随访1年。我们研究的主要结论是：1. ACV治疗组中67%出现眼部受累，这一比例与我们的回顾性组（59%）及文献报道（71%）相当。然而，与未治疗的回顾性组（21%）相比，严重长期并发症的发生率极低（4%）。2. 在任何接受ACV治疗的患者中均无需使用类固醇治疗。3. ACV耐受性良好，所有患者均无需停药。高剂量ACV和避免使用类固醇似乎可消除AHZO的严重并发症。
