Vaccines may have future in ocular HZV and HPV, but effect on eye unknown

Vaccines may have a role in corneal and external ocular disease, specifically herpeszoster virus (HZV) and human papillomavirus (HPV), because of the successes of the vaccines inpreventing systemic diseases, according to Minas Coroneo, MD.

"HZV and HPV are highly prevalent in the United States and are associated with high morbidityand cost," said Dr. Coroneo, chairman, Department of Ophthalmology, University of New SouthWales, Sydney, Australia. "Ophthalmologists are almost been bystanders in the development ofvaccines for these viruses."

The Shingles Prevention Study found that a vaccine reduces the incidence of HZV. There is a 10%to 25% chance of getting HZV during an individual's lifetime and the associated complications,such as loss of sight, are substantial. In 2006, the FDA licensed a vaccine to help reduce therisk of developing shingles (Zostovax, Merck [26 mg]) to prevent HZV in patients older than 60years. The drug is associated with mild side effects of headache and injection sitereactions.

In 2006, the FDA also approved human papillomavirus quadrivalent (types 6, 11, 16, 18) vaccine,recombinant (Gardasil, Merck) to prevent cervical cancer and precancerous genital lesions andwarts resulting from HPV types 6, 11, 16, and 18, the last two being the worst. HPV is thesecond leading cause of cancer in women. Dr. Coroneo said that 80% of sexually activeindividuals would be exposed to HPV, which invades the stem cells, during theirlifetime.

The aim of the vaccine is to reduce cervical, vulvar, and vaginal cancer. It is unknown whateffect a vaccine against HPV would have in the eye; however, the vaccine might be effective insome head and neck cancers. The virus has been documented in the eye; there may be respirablevirus particles in excimer laser plumes.

A vaccine for herpes simplex virus will not be available soon, but vaccines may becomeavailable against Pseudomonas aeruginosa and acanthomaeba.