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

Abstract

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.

The validity of clinical feature profiles for cytomegaloviral anterior segment infection

“…In the patients with CMV endotheliitis, however, high IOP was not described in every case. In Koizumi's eight-case series of PCR-proven CMV endotheliitis, four had good IOP under medical control and two had normal IOP as in our five patients (patients 22,26,27,28, and 29) [10]. Contrary, in Chee's study of ten cases of PCR-proven CMV endotheliitis, all of them presented with high IOP.…”

“…Oral valganciclovir [7], topical ganciclovir [10], intravenous ganciclovir, and intravitreal ganciclovir injection [8] have been suggested as treatment options to suppress the intraocular CMV infection. We tried several treatment protocols on our patients and found intravitreal ganciclovir (2 mg/0.05 ml) as the loading dosage combined with oral valganciclovir, which was prescribed according to the severity of the post-injection inflammation index, may be a good treatment strategy for CMV anterior uveitis [26].…”

Clinical Outcomes in Cytomegalovirus-Positive Posner-Schlossman Syndrome Patients Treated With Topical Ganciclovir Therapy

“…[11][12][13] In the literature, induction therapy for CMV infection included the systemic administration of ganciclovir and valganciclovir, 1-2, 5, 9, 14-17 and the intravitreal injection of ganciclovir. 18 Patients experienced a high recurrence rate after ceasing the treatment. 8 Topical antiviral agents such as acyclovir, ganciclovir, and valganciclovir have been used as a maintenance therapy in previous studies.…”

Comparison of the ocular characteristics of anterior uveitis caused by herpes simplex virus, varicella-zoster virus, and cytomegalovirus

“…Cytomegalovirus (CMV) is also known to cause AU in immunocompetent individuals [4][5][6][7][8][9][10][11][12]. The diagnosis of AU caused by these viruses (HSV-AU, VZV-AU, CMV-AU, respectively) has benefited from the use of PCR technology to detect the genomic DNA of the respective herpes virus in small amounts of ocular fluids [11,13,14].…”