Research article

BMC Ophthalmology

, 12:48

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Valacyclovir in the treatment of acute retinal necrosis

  • Simon RJ TaylorAffiliated withDivision of Immunology & Inflammation, Faculty of Medicine, Imperial College LondonRoyal Surrey County Hospital NHS Foundation TrustMoorfields Eye Hospital Email author 
  • , Robin HamiltonAffiliated withMoorfields Eye Hospital
  • , Claire Y HooperAffiliated withMoorfields Eye Hospital
  • , Lavnish JoshiAffiliated withRoyal Surrey County Hospital NHS Foundation TrustUCL Institute of Ophthalmology
  • , Jiten MorarjiAffiliated withRoyal Surrey County Hospital NHS Foundation Trust
  • , Nitin GuptaAffiliated withMoorfields Eye Hospital
  • , Sue L LightmanAffiliated withMoorfields Eye HospitalUCL Institute of Ophthalmology



To report the outcome of oral valacyclovir as the sole antiviral therapy for patients with acute retinal necrosis (ARN).


This study reports a retrospective, interventional case series of nine consecutive patients with ten eyes with newly diagnosed ARN treated with oral valacyclovir as the sole antiviral agent. Eight patients received oral valacyclovir 2 g tid (Valtrex, GlaxoSmithKline) and one patient with impaired renal function received oral 1 g tid. The main outcome measures were response to treatment, time to initial response to treatment, time to complete resolution of retinitis, best corrected visual acuity (BCVA) at final follow-up, retinal detachment and development of recurrent or second eye disease.


Retinitis resolved in ten of ten (100%) affected eyes. The median time to initial detectable response was seven days and the median time to complete resolution was 21 days. A final BCVA of 20/40 or better was achieved in 6/10 (60%) of eyes. 3/10 eyes (30%) developed a retinal detachment. No patients developed either disease reactivation or second eye involvement over the course of the study (mean follow up 31 weeks, range 7 to 104 weeks).


Treatment with oral valacyclovir as the sole antiviral therapy resulted in complete resolution of retinitis. Final BCVA and retinal detachment rate were comparable with previously reported outcomes for intravenous acyclovir.


Acute retinal necrosis Herpetic retinitis Acyclovir Valacyclovir