Iritis and Hypotony After Treatment With Intravenous Cidofovir for Cytomegalovirus Retinitis

Davis, Janet L.; Taşkintuna, İbrahim; Freeman, William R.; Weinberg, David V.; Feuer, William J.; Leonard, Robert E.

doi:10.1001/archopht.1997.01100150735008

Cited by 130 publications

(58 citation statements)

References 15 publications

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“…This is a substantially lower proportion than what has been reported in AIDS patients. 29,32 There might be several reasons for this low frequency in our study. First, most of our patients did not have the risk factors associated with ophthalmologic toxicity in the studies in AIDS patients, and all were given probenecid.…”

Section: Org Frommentioning

confidence: 66%

“…Several authors have reported ophthalmologic side effects from CDV. [28][29][30][31][32] These include uveitis, iritis, and ocular hypotonia and were reported in up to 44% of the patients. Risk factors reported as being associated with ophthalmologic side effects were increased serum creatinine, diabetes mellitus, treatment of retinitis, and use of protease inhibitors 29,32 whereas the use of probenecid was protective.…”

Section: Org Frommentioning

confidence: 99%

“…[28][29][30][31][32] These include uveitis, iritis, and ocular hypotonia and were reported in up to 44% of the patients. Risk factors reported as being associated with ophthalmologic side effects were increased serum creatinine, diabetes mellitus, treatment of retinitis, and use of protease inhibitors 29,32 whereas the use of probenecid was protective. 32 Until now, only a single case report has been published regarding the use of CDV after allogeneic SCT 33 although small pilot studies have been presented at scientific meetings.…”

Section: Org Frommentioning

confidence: 99%

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Cidofovir for cytomegalovirus infection and disease in allogeneic stem cell transplant recipients

Ljungman

Deliliers

Platzbecker

et al. 2001

Blood

195

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A retrospective study was performed to collect information regarding efficacy and toxicity of cidofovir (CDV) in allogeneic stem cell transplant patients. Data were available on 82 patients. The indications for therapy were cytomegalovirus (CMV) disease in 20 patients, primary preemptive therapy in 24 patients, and secondary preemptive therapy in 38 patients. Of the patients, 47 had received previous antiviral therapy with ganciclovir, foscarnet, or both drugs. The dosage of CDV was 1 to 5 mg/kg per week followed by maintenance every other week in some patients. The duration of therapy ranged from 1 to 134 days (median, 22 days). All patients received probenecid and prehydration. Ten of 20 (50%) patients who were treated for CMV disease (9 of 16 with pneumonia) responded to CDV therapy, as did 25 of 38 (66%) patients who had failed or relapsed after previous preemptive therapy and 15 of 24 (62%) patients in whom CDV was used as the primary preemptive therapy. Of the patients, 21 (25.6%) developed renal toxicity that remained after cessation of therapy in 12 patients. Fifteen patients developed other toxicities that were potentially due to CDV or the concomitantly given probenecid. No toxicity was seen in 45 (61.6%) patients. Cidofovir can be considered as second-line therapy in patients with CMV disease failing previous antiviral therapy. However, additional studies are needed before CDV can be recommended for preemptive therapy. (Blood. 2001;97:388-392)

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Section: Org Frommentioning

confidence: 66%

Section: Org Frommentioning

confidence: 99%

Section: Org Frommentioning

confidence: 99%

See 1 more Smart Citation

Cidofovir for cytomegalovirus infection and disease in allogeneic stem cell transplant recipients

Ljungman

Deliliers

Platzbecker

et al. 2001

Blood

195

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“…37,10 Although initially it appeared that the ophthalmologic adverse effect profile of IV cidofovir was better than that of intravitreous cidofovir, 27 a recent report suggests that this may not be true and that the incidence of cidofovir-related intraocular inflammation and hypotony may be similar with both forms of administration. 38 The growing use of local therapy, including ganciclovir implants and intravitreal injections of ganciclovir, foscarnet, and cidofovir, 39,40 prompted us to examine the incidence of and virologic features associated with clinical resistance to local cidofovir therapy. Clinical failure of intravitreal cidofovir treatment was documented for 3 (7%) of 41 patients who had received prior systemic anti-CMV therapy, while 22 patients who received intravitreal cidofovir as a first-line therapy responded well to intravitreal cidofovir injections.…”

Section: Commentmentioning

confidence: 99%

Clinical Failure of CMV Retinitis With Intravitreal Cidofovir Is Associated With Antiviral Resistance

Smith

Taşkintuna²,

Rahhal³

et al. 1998

Arch Ophthalmol

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To determine the incidence of clinical resistance to intraocular cidofovir injection for treatment of acquired immunodeficiency syndrome (AIDS)related cytomegalovirus (CMV) retinitis, and to identify virologic features associated with cidofovir treatment failure.Patients and Methods: Clinical resistance to intravitreal cidofovir was examined in 64 patients with CMV retinitis who received at least 1 injection of 20 µg of cidofovir. Histopathologic examination, culture, and polymerase chain reaction were used to detect CMV in ocular specimens. Antiviral resistance was assessed by plaque reduction assay and DNA sequencing.Results: Clinical resistance to intravitreal cidofovir injections was identified in 3 patients (5%) and was asso-ciated with prior oral ganciclovir or intravenous cidofovir use. Ganciclovir-and cidofovir-resistant CMV isolates were cultured from 2 patients and harbored resistanceassociated mutations in the UL97 and polymerase genes. Resistance mutations were also detected by direct analysis of vitreous. In 1 patient, different resistance mutations were identified in ocular vs extraocular CMV strains.

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“…Such treatment was frequently complicated by uveitis, which usually was anterior and could be associated with hypotony. 12 Vitreoretinal lymphoma is the most common uveitis masquerade syndrome in adults presenting with uveitis, causing intermediate uveitis and/or posterior uveitis with retinal infiltrates and retinal vasculitis. As is the case for the systemic lymphomas, the incidence of primary central nervous system lymphoma, including the vitreoretinal subset, is increased in those who are HIV-positive in comparison to those who are HIVnegative.…”

Section: Immune Recovery Uveitismentioning

confidence: 99%

Uveitis in Human Immunodeficiency Virus–infected Individuals

Wells¹,

Smith²

2015

International Ophthalmology Clinics

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Both infectious and non-infectious forms of uveitis may occur in persons who test positively for the human immunodeficiency virus (HIV). As the use of highly active antiretroviral therapy (HAART) has become standard of care in many countries, the spectrum of uveitis has changed in this group of people. Opportunistic infectious diseases, including cytomegalovirus (CMV) retinitis, continue to occur in HIV-positive patients who suffer from AIDS. Amongst immune competent persons, syphilis is a common cause of infectious uveitis. Several uveitic syndromes that respond to HAART have been specifically associated with HIV. Immune recovery uveitis is a common noninfectious uveitis in HAART-treated HIV-positive persons with a history of CMV retinitis.Other non-infectious forms of uveitis that occur in HIV-negative individuals may also affect HIV-positive persons, although the latter group may have a higher risk of entities such as HLA B27-associated uveitis, drug-induced uveitis and vitreoretinal lymphoma.This review presents an overview of the causes of uveitis in HIV-positive people. A comprehensive ocular and systemic history and examination, with directed testing, is recommended for all HIV-positive persons presenting with uveitis, due to the broad spectrum of diseases that may be associated with uveitis in these individuals.

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Iritis and Hypotony After Treatment With Intravenous Cidofovir for Cytomegalovirus Retinitis

Cited by 130 publications

References 15 publications

Cidofovir for cytomegalovirus infection and disease in allogeneic stem cell transplant recipients

Cidofovir for cytomegalovirus infection and disease in allogeneic stem cell transplant recipients

Clinical Failure of CMV Retinitis With Intravitreal Cidofovir Is Associated With Antiviral Resistance

Uveitis in Human Immunodeficiency Virus–infected Individuals

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