Intravitreal loading injection of ganciclovir with or without adjunctive oral valganciclovir for cytomegalovirus anterior uveitis.

Graefes Arch Clin Exp Ophthalmol 2010 Feb 27;248(2):263-9. Epub 2009 Sep 27.

Department of Ophthalmology, Chang Gung Memorial Hospital and Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.

Background: A pilot study was conducted to evaluate the therapeutic results of intravitreal ganciclovir injection as a loading dose with or without the following oral valganciclovir for the treatment of cytomegalovirus (CMV) anterior uveitis in immunocompetent patients.

Methods: Six consecutive patients in whom active CMV anterior uveitis was detected by polymerase chain reaction assay of the aqueous humor were enrolled between January 2006 and December 2008. These patients received an intravitreal injection of ganciclovir (2 mg/0.05 ml) as a loading dose. Subsequent use of oral valganciclovir (900 mg twice a day) was determined according to the severity of the post-injection aqueous inflammation. Immune status and anterior chamber reaction of individual patients, visual acuity, intraocular pressure (IOP) at study entry, and follow-up intervals were examined.

Results: The mean patient-month follow-up period after intravitreal injection was 14.7 months (range, 12-22 months). Two patients received only the intravitreal ganciclovir injection once and four patients had received the following oral valganciclovir for average 2.3 months (range, 1-4 months). With this treatment strategy, the best-corrected visual acuity of the patients improved or stabilized; the IOP and the inflammation of anterior chamber of the patients were well controlled at all time points and there were no treatment-associated complications by the end of follow-up.

Conclusions: In patients with CMV anterior uveitis, intravitreal ganciclovir injection as a loading dose with or without the following oral valganciclovir can control the inflammation and IOP well.

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http://dx.doi.org/10.1007/s00417-009-1195-2DOI Listing
February 2010
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References

(Supplied by CrossRef)

SP Chee et al.
Am J Ophthalmol 2008

I Schryver de et al.
Br J Ophthalmol 2006

WM Hart Jr et al.
Am J Ophthalmol 1978

SB Teoh et al.
Eye 2005

LA Boxtel van et al.
Ophthalmology 2007

RN Gelder Van et al.
Am J Ophthalmol 2008

H Mietz et al.
Graefes Arch Clin Exp Ophthalmol 2000

NN Markomichelakis et al.
Ophthalmology 2002

DJ Winston et al.
Transplantation 2003

DE Henderly et al.
Ophthalmology 1987

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