Long-Term Outcome of Treatment with 2% Topical Ganciclovir Solution in Cytomegalovirus Anterior Uveitis and Corneal Endotheliitis

Po-Jui Chen; I-Huang Lin; Yi-Chun Chi; Chun-Chieh Lai; Jia-Horung Hung; Sung-Huei Tseng; Yi-Hsun Huang

doi:10.2147/IDR.S370905

Long-Term Outcome of Treatment with 2% Topical Ganciclovir Solution in Cytomegalovirus Anterior Uveitis and Corneal Endotheliitis

Infect Drug Resist. 2022 Jun 29:15:3395-3403. doi: 10.2147/IDR.S370905. eCollection 2022.

Authors

Po-Jui Chen¹, I-Huang Lin¹, Yi-Chun Chi², Chun-Chieh Lai¹, Jia-Horung Hung¹, Sung-Huei Tseng¹, Yi-Hsun Huang¹

Affiliations

¹ Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
² Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Abstract

Purpose: This study aimed to evaluate the therapeutic efficacy and long-term outcomes of treatment with topical 2% ganciclovir solution in immunocompetent patients with aqueous humor polymerase chain reaction (PCR)-proven cytomegalovirus (CMV) anterior uveitis and corneal endotheliitis.

Methods: We retrospectively reviewed the findings for immunocompetent patients diagnosed with CMV uveitis or endotheliitis based on clinical manifestations and polymerase chain reaction (PCR) examination results and treated with topical 2% ganciclovir solution at National Cheng Kung University Hospital. Clinical outcome measurements included evaluations of the response rate, relapses, resolution of anterior chamber inflammation, visual acuity, and intraocular pressure.

Results: The study included 38 eyes of 32 patients. Long-term administration of topical 2% ganciclovir significantly decreased keratic precipitates (p = 0.001), anterior chamber cells (p = 0.001), and reduced intraocular pressure (p < 0.001). Only one eye was unresponsive to topical ganciclovir treatment, and the recurrence decreased to 0.13 relapses per year. The presence of keratic precipitates and higher intraocular pressure at the initial presentation were significantly associated with recurrence (p = 0.036 and p = 0.001, respectively).

Conclusions: Long-term use of topical 2% ganciclovir solution is effective, safe, and applicable when commercialized ganciclovir gel is not available.

Keywords: cytomegalovirus; endotheliitis; ganciclovir; uveitis.

Grants and funding

This study was supported by the Ministry of Science and Technology Grant (MOST 110-2628-B-006 −018). The sponsor or funding organization had no role in the design or conduct of this research.