Effectiveness of Topical Ganciclovir 2% Monotherapy Versus Combined Steroid Therapy in Cytomegalovirus Endotheliitis.
Effectiveness of Topical Ganciclovir 2% Monotherapy Versus Combined Steroid Therapy in Cytomegalovirus Endotheliitis.
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DOI：
10.3390/jcm11195811
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发表时间：
2022-09-30
影响因子：
3.9
通讯作者：
Hou, Yu-Chih
中科院分区：
文献类型：
--
作者：
Kuo, Yu-Wei;Chang, En-Che;Lee, Chia-Yi;Lee, Shwu-Huey;Liang, I-Chia;Chen, Yi-Chun;Hou, Yu-Chih
我们旨在报告巨细胞病毒(CMV)性角膜内皮炎的临床表现和长期外用2%更昔洛韦加用和不加用激素的结果。这项回顾性干预性研究包括CMV DNA阳性诊断为CMV角膜内皮炎的患者13例15只眼，在第三转诊中心长期外用2%更昔洛韦滴眼液治疗，中位随访时间为17个月。眼部表现包括角膜沉淀物(KPS)(100%)、高眼压(93.3%)、虹膜炎(60%)、角膜水肿(60%)和被蛾侵蚀的虹膜萎缩(60%)。经长期治疗后，角膜水肿、虹膜炎症和屈光度均明显下降(有效率分别为72%、76%和70%；p=0.024，p=0.006和p<；0.001)。治疗后视力和眼压均有明显改善(治疗前和治疗后分别为0.52和0.22；治疗前和治疗后平均眼压分别为42 mm Hg和12 mm Hg；p=0.001和p<；0.001)。治疗后内皮细胞六角形细胞比例明显改善(效应大小：82%；P=0.035)。非类固醇组使用的抗青光眼药物较少(有效率：79%；p=0.034)。使用2%更昔洛韦的局部长期维持治疗不仅提供了有效的治疗和减少复发，而且还降低了与激素联合使用相关的高眼压。
We aimed to report the clinical manifestations of cytomegalovirus (CMV) corneal endotheliitis and the results of long-term treatment with topical ganciclovir 2% with and without steroids. This retrospective, interventional study included 15 eyes of 13 patients diagnosed with CMV corneal endotheliitis by positive CMV DNA and treated with long-term topical ganciclovir 2% eye drops at a tertiary referral center and the median follow-up period was 17 months. Ocular manifestations included keratic precipitates (KPs) (100%), elevated IOP (93.3%), iritis (60%), corneal edema (60%), and moth-eaten iris atrophy (60%). After long-term treatment, corneal edema, iritis, and KPs significantly decreased (effect size: 72%, 76% and 70%, respectively; p = 0.024, p = 0.006 and p < 0.001, respectively). Both the logMAR acuity and IOP significantly improved (median logMAR was 0.52 before treatment and 0.22 after treatment; median IOP was 42 mmHg before treatment and 12 mmHg after treatment; p = 0.001 and p < 0.001, respectively). The ECD was maintained (effect size: 80%), and the percentage of hexagonal cell ratio of endothelial cells significantly improved after treatment (effect size: 82%; p = 0.035). Fewer anti-glaucoma medications were used in the non-steroid group (effect size: 79%; p = 0.034). Long-term maintenance treatment with topical ganciclovir 2% monotherapy not only provides effective therapy and reduces recurrence, but also decreases the high IOP related to the combination of steroids used.
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DOI：
10.1007/s00417-018-4111-9
发表时间：
2018-12
期刊：
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie
影响因子：
--
作者：
Miyazaki D;Shimizu D;Shimizu Y;Inoue Y;Inoue T;Higaki S;Ueta M;Sugita S;Real-time PCR for ocular cytomegalovirus infection study group
通讯作者：
Real-time PCR for ocular cytomegalovirus infection study group
影响因子：
4.1
作者：
AKINGBEHIN, AO
通讯作者：
AKINGBEHIN, AO
影响因子：
1.5
作者：
Shokoohi-Rad, Saeed;Daneshvar, Ramin;Rajaee, Parisa
通讯作者：
Rajaee, Parisa
影响因子：
13.7
作者：
Kandori, Michiko;Inoue, Tomoyuki;Tano, Yasuo
通讯作者：
Tano, Yasuo
影响因子：
13.7
作者：
Koizumi, Noriko;Suzuki, Takashi;Kinoshita, Shigeru
通讯作者：
Kinoshita, Shigeru