Original Investigation

Time-Varying Effects of Valacyclovir Prophylaxis in the Zoster Eye Disease Study

JAMA Ophthalmology 10.1001/jamaophthalmol.2026.3202

August 13, 2026 at 11:00 AM EDT

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In this post hoc exploratory analysis of the ZEDS randomized clinical trial, prophylactic valacyclovir decreased probability of subsequent zoster-related keratitis and IR, although statistical significance was not reached. Protective effects of valacyclovir prophylaxis were localized to early treatment and observation periods, supporting previously published recommendation of 1 year of prophylaxis.

Corresponding Author: David B. Warner, MD, Department of Ophthalmology, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205 (dbwarner@uams.edu).

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