Kaufman H E, Varnell E D, Thompson H W
LSU Eye Center, Louisiana State University Medical Center School of Medicine, New Orleans 70112-2234, USA.
Arch Ophthalmol. 1998 Jun;116(6):777-80. doi: 10.1001/archopht.116.6.777.
To compare trifluridine eyedrops, cidofovir eyedrops, and penciclovir ophthalmic ointment for the treatment of herpes simplex virus type 1 keratitis.
New Zealand white rabbits were infected with the McKrae strain of herpes simplex virus type 1. Three days after viral inoculation, the rabbits were randomly assigned to treatment with 1% trifluridine, 0.2% cidofovir, 3% penciclovir ointment, or phosphate-buffered saline (for control) on various schedules. The severity of keratitis was graded in a masked manner.
Treatment with any of the antiviral drugs resulted in significantly less severe keratitis than treatment with phosphate-buffered saline. There was no statistically significant difference between eyes given trifluridine 2, 4, or 7 times a day and eyes given cidofovir 2 times a day (P=.06, P=.43, and P=.19, respectively, using the F test of the analysis of variance). Cidofovir given twice a day was significantly more effective than penciclovir given either 2 or 4 times a day (P<.001 and P=.002, respectively). Even with once-a-day dosage, all 3 drugs were significantly more effective than phosphate-buffered saline (P<.001 for all). There was no significant difference between once-a-day trifluridine and cidofovir treatments (P=.17). Trifluridine administered 5 times a day was as effective as 1% cidofovir. A similar degree of punctate keratitis was seen after 4 to 5 days in eyes treated with trifluridine at the highest frequency, 1% cidofovir, or penciclovir ointment.
Trifluridine treatment was highly effective in this rabbit model, even when given only once a day. Treatment with cidofovir was as effective as that with trifluridine.
Cidofovir and penciclovir treatments may prove to be effective against epithelial keratitis. Clinical trials of trifluridine, cidofovir, and penciclovir with lower treatment frequencies appear to be warranted.
比较曲氟尿苷滴眼液、西多福韦滴眼液和喷昔洛韦眼膏治疗单纯疱疹病毒1型角膜炎的效果。
用单纯疱疹病毒1型的McKrae毒株感染新西兰白兔。病毒接种3天后，将兔子随机分配，按照不同的给药方案分别用1%曲氟尿苷、0.2%西多福韦、3%喷昔洛韦眼膏或磷酸盐缓冲盐水（作为对照）进行治疗。以盲法对角膜炎的严重程度进行分级。
与用磷酸盐缓冲盐水治疗相比，使用任何一种抗病毒药物治疗的角膜炎严重程度均显著减轻。每天给药2次、4次或7次的曲氟尿苷治疗组与每天给药2次的西多福韦治疗组之间无统计学显著差异（分别使用方差分析的F检验，P = 0.06、P = 0.43和P = 0.19）。每天给药2次的西多福韦比每天给药2次或4次的喷昔洛韦显著更有效（分别为P < 0.001和P = 0.002）。即使是每天给药一次，所有3种药物都比磷酸盐缓冲盐水显著更有效（所有P < 0.001）。每天给药一次的曲氟尿苷和西多福韦治疗之间无显著差异（P = 0.17）。每天给药5次的曲氟尿苷与1%西多福韦效果相同。在以最高频率使用曲氟尿苷、1%西多福韦或喷昔洛韦眼膏治疗的眼睛中，4至5天后可见类似程度的点状角膜炎。
在该兔模型中，曲氟尿苷治疗非常有效，即使每天仅给药一次。西多福韦治疗与曲氟尿苷治疗效果相同。
西多福韦和喷昔洛韦治疗可能被证明对上皮性角膜炎有效。似乎有必要进行曲氟尿苷、西多福韦和喷昔洛韦较低治疗频率的临床试验。
