Is Valtrex Helpful in Treatment of Acute Zonal Occult Outer Retinopathy?

October 23, 2010

A small study in AJO demonstrated a nice response to Valtrex in these AZOOR patients. This suggests that the Herpes virus is indeed the culprit. Although AZOOR is rare, a larger, prospective study might be nice.




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19 Responses to “Is Valtrex Helpful in Treatment of Acute Zonal Occult Outer Retinopathy?”

  1. Jane on June 23rd, 2011 11:01 am

    I took Valtrex after having AZOOR for 9 years. I have seen no change at all.

  2. Dr. Ari Weitzner on June 26th, 2011 11:04 am

    if valtrex is started after the damage is done, we would not expect any change- so it depends on when it was started.

  3. Tonya on June 28th, 2011 7:55 pm

    If there is a study out there, I would volunteer, I was recently diagnosed with AZOOR and would love to regain my vision…even if it is a small amount

  4. ari weitzner on June 29th, 2011 1:20 pm

    im afraid vision cannot be restored after azoor has taken its toll–it causes too much damage and scarring. i think the best we can do is limit the damage.

  5. Nicole on July 22nd, 2011 8:56 am

    Hi Dr. –
    Can you tell me what the nice response was? Was it their vision loss was limited, was sight regained, did their flashing lights stop? Just curious as to how it was found responsive.

    I just started the Valtrex yesterday for my AZOOR.

  6. Dr. Ari Weitzner on July 24th, 2011 12:47 pm

    improvement in vision (even back to 20/20) and improvement in visual field loss.

  7. Cathie Eaton on October 5th, 2011 9:11 am

    I was diagnosed with AZOOR in June of 2001 after doctors searched six months for the cause of my visual field loss. I have been taking Valtrex for oral herpes for many years. I have not had any improvement in my symptoms—nor have they worsened. If there is a study I, too, would volunteer. I know my sight will not be returned, but I would like to help others not loose so much of theirs.

  8. ari on October 6th, 2011 1:46 pm

    valtrex is the only treatment i am aware of.

  9. Cherry on October 14th, 2011 10:33 am

    I was misdiagnosed with retinitis pigmentosa over a year ago. Tried eyedrops (can’t remember the name) and Diamox sequels (500mg bid) with no improvement. Just yesterday saw another retina specialist who diagnosed AZOOR. I am on steroid treatment, 30-day oral and 3 ocular injections at 60-day intervals, in addition to 6-12 months of immuno-supporession therapy.

  10. Crystal on February 16th, 2013 9:55 pm

    I was stable for 13 years. It has recently begun to spread. Would valtrex help? I have it here for oral herpes. What is the dose and for how long did treatment last?

  11. ari on February 17th, 2013 10:50 am

    valtrex may help azoor, but you have to take it under an ophthalmologist’s supervision.

  12. Crystal on February 18th, 2013 11:51 pm

    Thank you. I go back to Mass Eye and Ear next week, but they are under the impression that the etiology is unknown and there is no treatment. So far I have my original blind spot. But I have symptoms in a different area and some starting in the other eye and I’m hoping to prevent more damage. Interestingly symptoms did coincide more or less with a herpes outbreak. Where could I go to find an MD who knows? I’m willing to travel. Thank you

  13. ari on February 19th, 2013 10:06 am

    the mass eye and ear is a world-class institution. why do you think you need an opinion elsewhere? Of course, if you are feeling uncertain with your present doctors, then a second opinion may reassure you.

  14. Crystal on February 20th, 2013 7:39 am

    I agree about their reputation and I feel lucky to live nearby, but… They maintain that no one knows what causes AZOOR and there is no treatment. Clearly not true. You know of people valtrex has helped. I also read a study from Barcelona that details candida famata as the culprit in some cases. I also have some vascular issues where my vessels are beading and leaking a but and don’t stretch all the way to the periphery and they are unsure if that presentation when coupled with AZOOR sxs. I have found in life that as good as professionals are, no one person knows everything and you have to be active in your own care. I would like to prevent additional vision loss. I know I have HSV I and II and CMV with a flare coinciding with the exacerbation of AZOOR sxs. To me valtrex seems worth a shot. We’ll see what they say Tues- but I’d love someone who would entertain the possibility that it could be treated.

  15. ari on February 20th, 2013 10:02 am

    no one knows the cause. just some theories. the data out there is not compelling. true, valtrex cant hurt so its reasonable to try

  16. Crystal on February 20th, 2013 8:11 pm

    Thank you so much for conversing with me. I really appreciate your time and expertise.

  17. ari on February 23rd, 2013 10:12 pm

    my pleasure. good luck!

  18. Carol on July 26th, 2013 10:36 pm

    I was diagnosed with Azoor 15 years ago in my left eye and lost all of my peripheral vision within 4 yrs. I would have central vision except for the mountain of inflammation behind my retina. After 11 years I started having double vision which got me back to the doctor and last year Azoor showed up in my right eye. On a desperate search to find a treatment I traveled to a research dr in Iowa and he offered valtrex as a treatment option. High dose valtrex and I have not missed a day since I started taking it. My right eye has not gotten any worse and I ramp up & down on my dose based on symptoms. I have also linked my symptoms ( pain, flashes of light etc) to hormones & stress. The 1-2 weeks following my cycle my symptoms are minimal so I take a low dose valtrex. Starting week 3 I increase dose. My doctor has allowed me to take meds as I feel I need to. I also did research of foods to avoid and foods to eat if you have herpes virus. I have had chicken pox before and fever blisters on ocassion. I have found a big link in diet also. I think that if you take valtrex as soon as possible it can stop disease from progressing but it has not restored my loss in my left eye. I try to avoid stress and minimize the multi tasking. ( I have 3 kids under 9 so this has its on challenges but I am surprised how much more calm I am. Stress triggers virus. Chocolate & alcohol trigger virus. Eating foods high in lysine and low in arsine (sp?) also limit virus from activating. I am in the medical field and after no help or direction I have done the best I could at connecting the dots and do everything I my power with the help of God to stop this terrible disease.
    My experience is that valtrex taken in a high dose helped stop the progress, eating a diet of foods that help surpress diet and limiting triggers have saved my vision thus far!

  19. ari on August 5th, 2013 11:50 pm

    thanks for sharing, god bless you, and good luck

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