The beneficial impact of filtration surgery on antiviral therapy cessation in patients with cytomegalovirus-related secondary glaucoma

Abstract Purpose Cytomegalovirus (CMV)-related keratouveitis elevates intraocular pressure (IOP). Antiviral therapy does not always control IOP and some patients do not tolerate systemic antiviral therapy because of the side effects. The purpose of this study is to evaluate the clinical characterist...

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Autores principales:	Yusuke Murai, Sotaro Mori, Fumio Takano, Kaori Ueda, Mari Sakamoto, Takuji Kurimoto, Sentaro Kusuhara, Yuko Yamada-Nakanishi, Makoto Nakamura
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Antiviral therapy Cytomegalovirus-related keratouveitis glaucoma surgery Trabeculectomy Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/83c6bd71607647f6b80043e7867465d0
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spelling	oai:doaj.org-article:83c6bd71607647f6b80043e7867465d02021-11-14T12:44:45ZThe beneficial impact of filtration surgery on antiviral therapy cessation in patients with cytomegalovirus-related secondary glaucoma10.1186/s12886-021-02155-31471-2415https://doaj.org/article/83c6bd71607647f6b80043e7867465d02021-11-01T00:00:00Zhttps://doi.org/10.1186/s12886-021-02155-3https://doaj.org/toc/1471-2415Abstract Purpose Cytomegalovirus (CMV)-related keratouveitis elevates intraocular pressure (IOP). Antiviral therapy does not always control IOP and some patients do not tolerate systemic antiviral therapy because of the side effects. The purpose of this study is to evaluate the clinical characteristics of patients with CMV-related keratouveitis and determine the impact of glaucoma surgeries on the postoperative antiviral therapy regimen. Methods We enrolled twenty-two patients with CMV-DNA-positive keratouveitis between June 2012 and July 2019 in Kobe University Hospital. The following clinical parameters were collected: gender, age, history of previous intraocular surgery, antiviral medications, visual acuity, IOP, glaucoma drug score, corneal endothelial cells density, and the mean deviation of a Humphrey visual field test at the first visit and before and 1 year after glaucoma surgery. Results All twenty-two patients started on oral and/or topical antiviral therapy. Eighteen patients needed glaucoma surgery despite their antiviral medications. Nine patients underwent trabeculotomy (TLO) and nine underwent trabeculectomy (TLE) as the first surgical intervention. Six of patients who initially underwent TLO and two of the patients who initially underwent TLE required additional TLE within 1 year. Each of the 15 patients who underwent at least 1 TLE showed a reduction in the magnitude and variation of IOP and glaucoma drug scores and 13 patients were able to discontinue antiviral therapy. For the remaining 4 patients, IOP and inflammation were controlled but with antiviral medications. Conclusions In patients with CMV-related keratouveitis, TLE decreases and stabilizes IOP and contributes to withdrawal from antiviral medications.Yusuke MuraiSotaro MoriFumio TakanoKaori UedaMari SakamotoTakuji KurimotoSentaro KusuharaYuko Yamada-NakanishiMakoto NakamuraBMCarticleAntiviral therapyCytomegalovirus-related keratouveitisglaucoma surgeryTrabeculectomyOphthalmologyRE1-994ENBMC Ophthalmology, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Antiviral therapy Cytomegalovirus-related keratouveitis glaucoma surgery Trabeculectomy Ophthalmology RE1-994
spellingShingle	Antiviral therapy Cytomegalovirus-related keratouveitis glaucoma surgery Trabeculectomy Ophthalmology RE1-994 Yusuke Murai Sotaro Mori Fumio Takano Kaori Ueda Mari Sakamoto Takuji Kurimoto Sentaro Kusuhara Yuko Yamada-Nakanishi Makoto Nakamura The beneficial impact of filtration surgery on antiviral therapy cessation in patients with cytomegalovirus-related secondary glaucoma
description	Abstract Purpose Cytomegalovirus (CMV)-related keratouveitis elevates intraocular pressure (IOP). Antiviral therapy does not always control IOP and some patients do not tolerate systemic antiviral therapy because of the side effects. The purpose of this study is to evaluate the clinical characteristics of patients with CMV-related keratouveitis and determine the impact of glaucoma surgeries on the postoperative antiviral therapy regimen. Methods We enrolled twenty-two patients with CMV-DNA-positive keratouveitis between June 2012 and July 2019 in Kobe University Hospital. The following clinical parameters were collected: gender, age, history of previous intraocular surgery, antiviral medications, visual acuity, IOP, glaucoma drug score, corneal endothelial cells density, and the mean deviation of a Humphrey visual field test at the first visit and before and 1 year after glaucoma surgery. Results All twenty-two patients started on oral and/or topical antiviral therapy. Eighteen patients needed glaucoma surgery despite their antiviral medications. Nine patients underwent trabeculotomy (TLO) and nine underwent trabeculectomy (TLE) as the first surgical intervention. Six of patients who initially underwent TLO and two of the patients who initially underwent TLE required additional TLE within 1 year. Each of the 15 patients who underwent at least 1 TLE showed a reduction in the magnitude and variation of IOP and glaucoma drug scores and 13 patients were able to discontinue antiviral therapy. For the remaining 4 patients, IOP and inflammation were controlled but with antiviral medications. Conclusions In patients with CMV-related keratouveitis, TLE decreases and stabilizes IOP and contributes to withdrawal from antiviral medications.
format	article
author	Yusuke Murai Sotaro Mori Fumio Takano Kaori Ueda Mari Sakamoto Takuji Kurimoto Sentaro Kusuhara Yuko Yamada-Nakanishi Makoto Nakamura
author_facet	Yusuke Murai Sotaro Mori Fumio Takano Kaori Ueda Mari Sakamoto Takuji Kurimoto Sentaro Kusuhara Yuko Yamada-Nakanishi Makoto Nakamura
author_sort	Yusuke Murai
title	The beneficial impact of filtration surgery on antiviral therapy cessation in patients with cytomegalovirus-related secondary glaucoma
title_short	The beneficial impact of filtration surgery on antiviral therapy cessation in patients with cytomegalovirus-related secondary glaucoma
title_full	The beneficial impact of filtration surgery on antiviral therapy cessation in patients with cytomegalovirus-related secondary glaucoma
title_fullStr	The beneficial impact of filtration surgery on antiviral therapy cessation in patients with cytomegalovirus-related secondary glaucoma
title_full_unstemmed	The beneficial impact of filtration surgery on antiviral therapy cessation in patients with cytomegalovirus-related secondary glaucoma
title_sort	beneficial impact of filtration surgery on antiviral therapy cessation in patients with cytomegalovirus-related secondary glaucoma
publisher	BMC
publishDate	2021
url	https://doaj.org/article/83c6bd71607647f6b80043e7867465d0
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The beneficial impact of filtration surgery on antiviral therapy cessation in patients with cytomegalovirus-related secondary glaucoma

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