Slightly more than half of the investigators from the Zoster Eye Disease Study (ZEDS) treat herpes zoster ophthalmicus (HZO) with prolonged oral antivirals along with topical steroids, and two-thirds believe this regimen is effective, a recent study says.

In an effort to determine practices and opinions among study investigators in ZEDS regarding suppressive valacyclovir treatment for recent-onset and chronic

HZO, a team of investigators collected data from an Internet-based survey sent to 170 ZEDS investigators. The study polled the ZEDS researchers on treatment practices for stromal keratitis in HZO and their opinions regarding the efficacy of prolonged antiviral prophylaxis. The response rate was 72.4% (123 out of 170).

The study found topical steroids and oral antivirals were used by the majority of respondents for stromal keratitis in both recent onset (69.1%, or 85 out of 123) and chronic HZO (63.4%, or 78 out of 123). Additionally, researchers reported the duration of treatment was similar in both recent onset and chronic HZO with 50.4% (124 out of 246) of ZEDS investigators using prolonged treatment for stromal keratitis due to recent-onset or chronic HZO. The study also reported 70.7% (87 out of 123) ZEDS respondents believed oral antivirals were effective during treatment.

“The ZEDS randomized placebo controlled clinical trial of prolonged suppressive valacyclovir treatment is a unique opportunity to obtain evidence to determine standard of care in treatment of HZO to reduce complications and improve outcomes,” researchers said.

They added: completion of ZEDS was feasible and necessary to determine whether or not these practices are effective. “Participation in this study is necessary to obtain evidence to support treatment that many ophthalmologists use and believe is effective,” investigators said.

Lo DM, Jeng BH, Gillespie C, et al. Current practice patterns and opinions on the management of recent-onset or chronic herpes zoster ophthalmicus of zoster eye disease study investigators. Cornea. 2019 Jan;38(1):13-17.