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Efficacy and tolerance of systemic ganciclovir as a treatment for cytomegalovirus‐associated anterior uveitis in inmunocompetent patients
Author(s) -
ESPOSITO F,
BODAGHI B
Publication year - 2010
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2010.416.x
Subject(s) - ganciclovir , medicine , uveitis , regimen , cytomegalovirus , anterior uveitis , surgery , retrospective cohort study , behcet's disease , intraocular pressure , human cytomegalovirus , disease , herpesviridae , ophthalmology , immunology , viral disease , virus
Purpose To assess the utility of systemic, intravitreal or topical ganciclovir, as a treatment for PCR‐proven cytomegalovirus (CMV)‐associated anterior uveitis. Methods Retrospective interventional case series of 39 consecutive patients treated in a single centre between 2002 and 2009. Main outcome measures included intraocular pressure (IOP) and anterior chamber inflammation. Results All 35 patients with at least a 12‐month follow‐up responded to the first treatment regimen. Mean IOP dropped from 32 (SD 7) to 18 (SD 2) mmHg after 1 week and remained within normal values throughout the treatment course, with progressive lowering of antihypertensive therapy. Relapses occurred in 50% of cases within one year. Mean time to relapse was 5.7 months (range: 0.5‐12). Long‐term antivirals were needed in 15% of cases whereas intolerance occurred in 15% of cases. Intravitreal ganciclovir may be proposed in patients with systemic intolerance but multiple injections are required. Long‐term topical ganciclovir was able to control the disease in selected cases. Conclusion Systemic Ganciclovir is effective in controlling CMV‐induced chronic ocular hypertension and anterior chamber inflammation, but even prolonged treatment does not protect from relapses. Repeated short‐course regimens seem to be an appropriate strategy.