Vitreou Penetration of Orally Adminitered Valacyclovir Original Reearch Article

Purpoe To invetigate the vitreou penetration of acyclovir, the active metabolite of valacyclovir, after oral adminitration of valacyclovir. Deign Propective, interventional cae erie. Method Ten patient cheduled for elective par plana vitrectomy at a ingle academic intitution were given three oral doe of valacyclovir 1000 mg eight hour apart the day before urgery, with a fourth doe on the morning of urgery. Blood and undiluted vitreou ample were obtained during urgery and ubequently were analyzed with high-performance liquid chromatography to determine the concentration of acyclovir preent. Reult Ten eye of 10 ubject ranging in age from 46 to 83 year were included. All patient had normal renal and hepatic function a confirmed by metabolic panel obtained before urgery. Mean erum acyclovir concentration ± tandard deviation wa 4.41 ± 0.88 μg/ml (range, 3.18 to 5.92 μg/ml), mean vitreou acyclovir concentration wa 1.03 ± 0.23 μg/ml (range, 0.67 to 1.33 μg/ml), and mean vitreou-to-erum concentration ratio of acyclovir wa 0.24 ± 0.06 (range, 0.16 to 0.34). Concluion Orally adminitered valacyclovir reult in ubtantial vitreou penetration of acyclovir. The vitreou concentration achieved in noninflamed eye are within the reported inhibitory range for mot train of herpe implex 1, herpe implex 2, and varicella zoter viru. Thi ugget that orally adminitered valacyclovir may be an alternative to intravenou acyclovir in the treatment of acute retinal necroi.