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Cytomegalovirus anterior uveitis: outcome of treatment
  1. S-P Chee1,2,3,
  2. A Jap1,4
  1. 1Ocular Inflammation and Immunology Service, Singapore National Eye Centre, Singapore, Singapore
  2. 2Department of Ophthalmology, Yong Loo Lin School of Medicine National University Health System, Singapore, Singapore
  3. 3Singapore Eye Research Institute, Singapore, Singapore
  4. 4Division of Ophthalmology, Changi General Hospital, Simei, Singapore, Singapore
  1. Correspondence to Soon-Phaik Chee, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751, Singapore; chee.soon.phaik{at}snec.com.sg

Abstract

Aim To determine the outcome of antiviral treatment of cytomegalovirus (CMV) anterior uveitis.

Methods A retrospective review of patients from Singapore National Eye Centre with CMV anterior uveitis diagnosed by aqueous polymerase chain reaction. Ganciclovir treatment consisted of systemic, topical, intravitreal injections or intravitreal implant. The main outcome measure was resolution of anterior chamber inflammation.

Results 72 eyes of 70 patients were positive for CMV DNA. 35 eyes were treated (23 eyes with acute recurrent anterior uveitis and 12 eyes with chronic anterior uveitis). Eyes that did not respond or recurred with one treatment may receive another course of treatment. There were 47 treatment episodes, 36 (76.6%) of which resulted in a response. However, there were 27 (75.0%) episodes of recurrences after stopping treatment. Systemic and intravitreal ganciclovir and ganciclovir implant had good response rates but also had very high recurrence rates. Ganciclovir gel had moderate response rates, but its recurrence rates were also lower than those of the other modalities.

Conclusions Ganciclovir gel had lower recurrence rates than the systemic ganciclovir and the implant and should be considered as an option for treatment of CMV anterior uveitis.

  • Cytomegalovirus anterior uveitis
  • valganciclovir
  • polymerase chain reaction
  • anterior chamber
  • infection
  • inflammation
  • treatment medical

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Footnotes

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Singapore Eye Research Institute institutional review board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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