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Cytomegalovirus Anterior Uveitis: Clinical Characteristics and Long-term Outcomes in a French Series.
Am J Ophthalmol. 2018 10; 194:134-142.AJ

Abstract

PURPOSE

To report the characteristics of cytomegalovirus anterior uveitis (CMV AU) and the comparative response to 2 types of antiviral induction treatments.

DESIGN

Retrospective, consecutive case series.

METHODS

Consecutive immunocompetent patients with polymerase chain reaction-positive CMV AU were included. For each patient, best-corrected visual acuity (BCVA), intraocular pressure (IOP), clinical characteristics at baseline and latest visit, and number of relapses were recorded. All patients received an induction dose of intravenous (IV) ganciclovir or oral valganciclovir and a maintenance dose of oral valganciclovir.

RESULTS

Thirty-six eyes of 35 patients were included. Mean age at diagnosis was 55.5 years. Mean follow-up was 4.13 years. Posner-Schlossman and chronic nonspecific AU were observed in 69.4% and 30.6% of cases, respectively. We did not observe any case of Fuchs uveitis or endotheliitis. At baseline, mean BCVA was 20/25 and mean IOP was 29.19 mm Hg. Keratic precipitates and iris atrophy were seen in 91.4% and 25.7% of cases. Induction therapy consisted of oral valganciclovir and IV ganciclovir in 40% and 60% of cases. A total of 94.2% of patients responded to the first line of therapy. Recurrence was reported in 73.5% of cases. Glaucoma surgery was necessary in 25.7% of cases. Early initiation of antiviral therapy (≤700 days) seemed to decrease the recourse to glaucoma surgery. Both IV and oral induction treatments seemed similar in terms of BCVA changes and occurrence of relapses.

CONCLUSIONS

Characteristics of CMV AU seem to show specificities in this French cohort. Early initiation of antiviral therapy seems to reduce the severity of glaucoma.

Authors+Show Affiliations

Ophthalmology Department, Reference Center in Rare Diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, University Paris VI, Paris, France. Electronic address: saratouhami@gmail.com.Ophthalmology Department, Reference Center in Rare Diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, University Paris VI, Paris, France.Ophthalmology Department, Reference Center in Rare Diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, University Paris VI, Paris, France.Virology Department, Hôpital Cochin, University Paris V, Paris, France.Ophthalmology Department, Reference Center in Rare Diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, University Paris VI, Paris, France.Ophthalmology Department, Reference Center in Rare Diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, University Paris VI, Paris, France.Virology Department, Hôpital Cochin, University Paris V, Paris, France.Ophthalmology Department, Reference Center in Rare Diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, University Paris VI, Paris, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30055154

Citation

Touhami, Sara, et al. "Cytomegalovirus Anterior Uveitis: Clinical Characteristics and Long-term Outcomes in a French Series." American Journal of Ophthalmology, vol. 194, 2018, pp. 134-142.
Touhami S, Qu L, Angi M, et al. Cytomegalovirus Anterior Uveitis: Clinical Characteristics and Long-term Outcomes in a French Series. Am J Ophthalmol. 2018;194:134-142.
Touhami, S., Qu, L., Angi, M., Bojanova, M., Touitou, V., Lehoang, P., Rozenberg, F., & Bodaghi, B. (2018). Cytomegalovirus Anterior Uveitis: Clinical Characteristics and Long-term Outcomes in a French Series. American Journal of Ophthalmology, 194, 134-142. https://doi.org/10.1016/j.ajo.2018.07.021
Touhami S, et al. Cytomegalovirus Anterior Uveitis: Clinical Characteristics and Long-term Outcomes in a French Series. Am J Ophthalmol. 2018;194:134-142. PubMed PMID: 30055154.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cytomegalovirus Anterior Uveitis: Clinical Characteristics and Long-term Outcomes in a French Series. AU - Touhami,Sara, AU - Qu,Lise, AU - Angi,Martina, AU - Bojanova,Magdalena, AU - Touitou,Valérie, AU - Lehoang,Phuc, AU - Rozenberg,Flore, AU - Bodaghi,Bahram, Y1 - 2018/07/26/ PY - 2018/04/01/received PY - 2018/07/17/revised PY - 2018/07/18/accepted PY - 2018/7/29/pubmed PY - 2019/8/31/medline PY - 2018/7/29/entrez SP - 134 EP - 142 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 194 N2 - PURPOSE: To report the characteristics of cytomegalovirus anterior uveitis (CMV AU) and the comparative response to 2 types of antiviral induction treatments. DESIGN: Retrospective, consecutive case series. METHODS: Consecutive immunocompetent patients with polymerase chain reaction-positive CMV AU were included. For each patient, best-corrected visual acuity (BCVA), intraocular pressure (IOP), clinical characteristics at baseline and latest visit, and number of relapses were recorded. All patients received an induction dose of intravenous (IV) ganciclovir or oral valganciclovir and a maintenance dose of oral valganciclovir. RESULTS: Thirty-six eyes of 35 patients were included. Mean age at diagnosis was 55.5 years. Mean follow-up was 4.13 years. Posner-Schlossman and chronic nonspecific AU were observed in 69.4% and 30.6% of cases, respectively. We did not observe any case of Fuchs uveitis or endotheliitis. At baseline, mean BCVA was 20/25 and mean IOP was 29.19 mm Hg. Keratic precipitates and iris atrophy were seen in 91.4% and 25.7% of cases. Induction therapy consisted of oral valganciclovir and IV ganciclovir in 40% and 60% of cases. A total of 94.2% of patients responded to the first line of therapy. Recurrence was reported in 73.5% of cases. Glaucoma surgery was necessary in 25.7% of cases. Early initiation of antiviral therapy (≤700 days) seemed to decrease the recourse to glaucoma surgery. Both IV and oral induction treatments seemed similar in terms of BCVA changes and occurrence of relapses. CONCLUSIONS: Characteristics of CMV AU seem to show specificities in this French cohort. Early initiation of antiviral therapy seems to reduce the severity of glaucoma. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/30055154/Cytomegalovirus_Anterior_Uveitis:_Clinical_Characteristics_and_Long_term_Outcomes_in_a_French_Series_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(18)30402-1 DB - PRIME DP - Unbound Medicine ER -