Cytomegalovirus anterior uveitis: outcome of treatment
Cytomegalovirus anterior uveitis: outcome of treatment
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DOI：
10.1136/bjo.2009.167767
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发表时间：
2010-12-01
影响因子：
4.1
通讯作者：
Jap, A.
中科院分区：
文献类型：
--
作者：
Chee, S-P;Jap, A.
目的探讨巨细胞病毒(CMV)前葡萄膜炎的抗病毒治疗效果。方法对新加坡国家眼科中心就诊的CMV前葡萄膜炎患者进行回顾性分析。更昔洛韦的治疗包括全身注射、局部注射、玻璃体内注射或玻璃体内植入。主要观察指标为前房炎症消退情况。结果70例72眼CMV DNA阳性。治疗35只眼，其中急性复发性前葡萄膜炎23只眼，慢性前葡萄膜炎12只眼。用一种治疗没有反应或复发的眼睛可能会接受另一疗程的治疗。共治疗47次，有效36次(76.6%)。停药后复发27例(75.0%)。全身和玻璃体内植入更昔洛韦和更昔洛韦有良好的应答率，但也有非常高的复发率。结论更昔洛韦凝胶的复发率低于全身用药和埋植剂，可作为治疗CMV前葡萄膜炎的一种选择。
Aim To determine the outcome of antiviral treatment of cytomegalovirus (CMV) anterior uveitis.Methods A retrospective review of patients from Singapore National Eye Centre with CMV anterior uveitis diagnosed by aqueous polymerase chain reaction. Ganciclovir treatment consisted of systemic, topical, intravitreal injections or intravitreal implant. The main outcome measure was resolution of anterior chamber inflammation.Results 72 eyes of 70 patients were positive for CMV DNA. 35 eyes were treated (23 eyes with acute recurrent anterior uveitis and 12 eyes with chronic anterior uveitis). Eyes that did not respond or recurred with one treatment may receive another course of treatment. There were 47 treatment episodes, 36 (76.6%) of which resulted in a response. However, there were 27 (75.0%) episodes of recurrences after stopping treatment. Systemic and intravitreal ganciclovir and ganciclovir implant had good response rates but also had very high recurrence rates. Ganciclovir gel had moderate response rates, but its recurrence rates were also lower than those of the other modalities.Conclusions Ganciclovir gel had lower recurrence rates than the systemic ganciclovir and the implant and should be considered as an option for treatment of CMV anterior uveitis.