Physician Survey for Study of Suppressive Antiviral Treatment to Reduce Chronic Ocular Disease and Postherpetic Neuralgia After Herpes Zoster Ophthalmicus

OBJECTIVES: The purpose of this study was to develop a consensus regarding the appropriate regimen to evaluate long-term suppressive antiviral treatment to reduce complications from herpes zoster ophthalmicus (HZO) and identify potential study sites. METHODS: In January 2013, a survey of 13 questions was distributed among cornea fellowship directors, board members of the Cornea Society and Ocular Microbiology and Immunology Group, and Kera-net Listserv members. Questions identified respondents' preferred antiviral regimens to administer for chronic or recurrent HZO, gauged the level of interest in participation in a planned randomized clinical trial, and assessed the number of HZO patients treated among specialists in the past year. RESULTS: Of the 171 respondents who completed the questionnaire, the majority identified as Kera-net Listserv members (107 of 171, 63%) and cornea fellowship directors (46 of 171, 27%). First choice of treatment was valacyclovir 500 mg 2 times per day (61 of 171, 36%), followed by acyclovir 800 mg 2 times per day (56 of 171, 33%), and then valacyclovir 1,000 mg daily (26.9%, 46 of 171). Among the choices, famciclovir consistently placed last among all the respondents (7 of 171, 4%). A majority (106 of 171, 62%) of all respondents, including 70% (26 of 37) of U. S. respondents of the high-volume practices, were interested in participating in a future randomized clinical trial evaluating whether treatment with oral antiviral medications for 1 year decreases complications of HZO. CONCLUSIONS: This survey highlights the strong interest in and support for further study of suppressive antiviral treatment regimens to reduce complications of HZO.