Bromovinyldeoxyuridine treatment of herpetic keratitis clinically resistant to other antiviral agents

Abstract

Patients suffering from dendritic and geographic corneal ulcers or herpetic stromal keratitis were treated with topical BVDU [(E)-5-(2-bromovinyl)-2'-deoxyuridine, bromovinyldeoxyuridine] 0.1% eyedrops administered during the day only at 1-hour intervals. Treatment with other antiviral drugs, i.e., idoxuridine, trifluridine, vidarabine or Zovirax had failed to ameliorate the ocular disease in 102 patients when their treatment was switched to BVDU eyedrops. Under BVDU therapy, dendritic keratitis in 44 patients healed within an average 7.8 days. Similarly, geographic corneal ulcers in 26 patients and stromal keratitis in 32 patients healed within an average period of 11.2 days and 30.7 days, respectively. Associated therapy with topical corticosteroids was stopped in 65 patients when the antiviral treatment was switched. However, topical corticosteroids had to be used together with BVDU drops to arrest stromal inflammation in 49 patients. Ultimately, 36 patients became corticosteroid-dependent. Except for local hypersensitivity reaction in three patients, BVDU eyedrops did not cause any toxic side effects.