Effect of Continuous 0.5% Ganciclovir Eye Drop Treatment in Secondary Glaucoma Associated with Cytomegalovirus Anterior Uveitis

Main Article Content

Takaaki Otsuka
Katsuhiko Yokoyama
Takako Nakamuro
Yuji Sakino
Satoko Nakano
Kenichi Kimoto
Toshiaki Kubota

Abstract

Purpose: The purpose of this study was to investigate the treatment outcomes of secondary glaucoma caused by cytomegalovirus (CMV)-anterior uveitis (AU) with continuous 0.5% ganciclovir eye drop.

Study Design: Retrospective observational study.

Place and Duration of Study: Department of Ophthalmology, Oita University Hospital, between January 2012 and December 2017.

Methodology: Nineteen eyes of 19 patients with secondary glaucoma associated with CMV-AU diagnosed by a polymerase chain reaction analysis from human aqueous samples were enrolled. They were treated with continuous 4-times-daily topical 0.5% ganciclovir in addition to topical steroids and anti-glaucoma medications. We performed glaucoma surgery for patients with poorly medically controlled intraocular pressure (IOP).

Results: Anterior chamber inflammation and IOP were controlled without systemic ganciclovir or glaucoma surgery during the follow-up period (mean: 59.2±27.0 months) in 9 (47%) eyes. Five (26%) eyes required systemic ganciclovir and ten (53%) eyes required glaucoma surgery. Patients were divided into two groups for the comparison: one group requiring glaucoma surgery and one treated with medication. The mean IOP and number of anti-glaucoma medications at the first visit were significantly higher in the surgery group than in the medication group. The mean number of IOP spikes per year (IOP >30 mmHg) was 1.4±0.9 in the surgery group and 0.4±0.5 in the medication group. The recurrence of anterior chamber inflammation was suppressed in both groups. The cumulative survival rate after glaucoma surgery was 80% at 12 months and 70% at 36 months.

Conclusion: The anterior chamber inflammation and IOP were controlled with continuous 0.5% ganciclovir eye drop treatment in half of the patients with CNV-AU. A high IOP at the first visit and frequent IOP spikes were risk factors for additional glaucoma surgeries.Cytomegalovirus

Keywords:
Cytomegalovirus, anterior uveitis, secondary glaucoma, ganciclovir, glaucoma surgery.

Article Details

How to Cite
Otsuka, T., Yokoyama, K., Nakamuro, T., Sakino, Y., Nakano, S., Kimoto, K., & Kubota, T. (2021). Effect of Continuous 0.5% Ganciclovir Eye Drop Treatment in Secondary Glaucoma Associated with Cytomegalovirus Anterior Uveitis. Ophthalmology Research: An International Journal, 14(1), 13-21. https://doi.org/10.9734/or/2021/v14i130179
Section
Original Research Article

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