Ganciclovir: a promising topical antiviral gel for herpetic keratitis

Abstract

Ganciclovir (GCV) is a potent broad-spectrum antiviral with proven efficacy against herpes viruses. As it inhibits viral but not cellular DNA, it is expected to avoid the toxicity associated with trifluridine – the only currently approved treatment for herpes simplex keratitis in the USA. Preclinical studies have demonstrated GCV to be as effective as trifluridine against experimental herpes simplex keratitis. Clinical studies conducted in Europe, Asia, and Africa that compared the efficacy and tolerability of GCV ophthalmic gel with acyclovir (ACV) ophthalmic ointment in patients with herpetic keratitis showed that GCV-treated patients had higher overall healing rates and lower relapse rates than ACV-treated patients. The ganciclovir gel formulation was also much better tolerated than the ACV ointment base. Finally, a controlled, masked, randomized series of 18 patients with adenoviral keratoconjunctivitis compared GCV gel with preservative-free artificial tears. Ganciclovir-treated patients experienced a shorter acute-disease phase and exhibited significantly fewer subepithelial infiltrates.