Requirement of longer term antiviral therapy in patients with cytomegalovirus anterior uveitis with corneal endothelial cell damage

Yosuke Harada,1,2 Ken Fukuda,1 Asami Nakahira,1 Kentaro Tada,1 Tamaki Sumi,1 Atsuki Fukushima1 1Department of Ophthalmology and Visual Science, Kochi Medical School, Nankoku, Japan; 2Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hirosh...

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Autores principales:	Harada Y, Fukuda K, Nakahira A, Tada K, Sumi T, Fukushima A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	cytomegalovirus anterior uveitis corneal endothelial cell polymerase chain reaction clinical course Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/ec68b07f3f7745d286e05ab50c6b48ee
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spelling	oai:doaj.org-article:ec68b07f3f7745d286e05ab50c6b48ee2021-12-02T04:11:48ZRequirement of longer term antiviral therapy in patients with cytomegalovirus anterior uveitis with corneal endothelial cell damage1177-5483https://doaj.org/article/ec68b07f3f7745d286e05ab50c6b48ee2018-07-01T00:00:00Zhttps://www.dovepress.com/requirement-of-longer-term-antiviral-therapy-in-patients-with-cytomega-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Yosuke Harada,1,2 Ken Fukuda,1 Asami Nakahira,1 Kentaro Tada,1 Tamaki Sumi,1 Atsuki Fukushima1 1Department of Ophthalmology and Visual Science, Kochi Medical School, Nankoku, Japan; 2Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan Background: The aim of the study was to investigate the efficacy of therapy in patients with cytomegalovirus (CMV) anterior uveitis. Patients and methods: We reviewed the records of patients with CMV anterior uveitis who attended our institution between October 2010 and December 2015 and who were confirmed to have CMV DNA in the aqueous humor by polymerase chain reaction analysis. Results: Fourteen immunocompetent patients (10 men and 4 women, total of 17 eyes) were enrolled. The mean ± SD age at the onset of antiviral therapy was 63.1 ± 11.3 years (range, 44–87 years). CMV DNA was not detected in the aqueous humor of 3 patients on initial testing, but it was detected on subsequent analysis. All patients underwent systemic antiviral therapy. Among the patients who were followed up for more than 6 months after starting systemic antiviral therapy, systemic antiviral therapy was successfully terminated in all 4 patients without corneal endothelial loss but had to be continued because of disease recurrence on its termination in 5 of 8 patients (62.5%) with corneal endothelial damage (P = 0.038). Conclusions: Patients with corneal endothelial cell loss are likely to require longer term antiviral therapy than those without endothelial damage. In addition, whereas definitive diagnosis of CMV anterior uveitis requires the detection of CMV DNA in aqueous humor by polymerase chain reaction, one-fifth of patients in the present study tested negative on initial examination. Keywords: cytomegalovirus, anterior uveitis, corneal endothelial cell, polymerase chain reaction, clinical courseHarada YFukuda KNakahira ATada KSumi TFukushima ADove Medical Pressarticlecytomegalovirusanterior uveitiscorneal endothelial cellpolymerase chain reactionclinical courseOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 1311-1316 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	cytomegalovirus anterior uveitis corneal endothelial cell polymerase chain reaction clinical course Ophthalmology RE1-994
spellingShingle	cytomegalovirus anterior uveitis corneal endothelial cell polymerase chain reaction clinical course Ophthalmology RE1-994 Harada Y Fukuda K Nakahira A Tada K Sumi T Fukushima A Requirement of longer term antiviral therapy in patients with cytomegalovirus anterior uveitis with corneal endothelial cell damage
description	Yosuke Harada,1,2 Ken Fukuda,1 Asami Nakahira,1 Kentaro Tada,1 Tamaki Sumi,1 Atsuki Fukushima1 1Department of Ophthalmology and Visual Science, Kochi Medical School, Nankoku, Japan; 2Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan Background: The aim of the study was to investigate the efficacy of therapy in patients with cytomegalovirus (CMV) anterior uveitis. Patients and methods: We reviewed the records of patients with CMV anterior uveitis who attended our institution between October 2010 and December 2015 and who were confirmed to have CMV DNA in the aqueous humor by polymerase chain reaction analysis. Results: Fourteen immunocompetent patients (10 men and 4 women, total of 17 eyes) were enrolled. The mean ± SD age at the onset of antiviral therapy was 63.1 ± 11.3 years (range, 44–87 years). CMV DNA was not detected in the aqueous humor of 3 patients on initial testing, but it was detected on subsequent analysis. All patients underwent systemic antiviral therapy. Among the patients who were followed up for more than 6 months after starting systemic antiviral therapy, systemic antiviral therapy was successfully terminated in all 4 patients without corneal endothelial loss but had to be continued because of disease recurrence on its termination in 5 of 8 patients (62.5%) with corneal endothelial damage (P = 0.038). Conclusions: Patients with corneal endothelial cell loss are likely to require longer term antiviral therapy than those without endothelial damage. In addition, whereas definitive diagnosis of CMV anterior uveitis requires the detection of CMV DNA in aqueous humor by polymerase chain reaction, one-fifth of patients in the present study tested negative on initial examination. Keywords: cytomegalovirus, anterior uveitis, corneal endothelial cell, polymerase chain reaction, clinical course
format	article
author	Harada Y Fukuda K Nakahira A Tada K Sumi T Fukushima A
author_facet	Harada Y Fukuda K Nakahira A Tada K Sumi T Fukushima A
author_sort	Harada Y
title	Requirement of longer term antiviral therapy in patients with cytomegalovirus anterior uveitis with corneal endothelial cell damage
title_short	Requirement of longer term antiviral therapy in patients with cytomegalovirus anterior uveitis with corneal endothelial cell damage
title_full	Requirement of longer term antiviral therapy in patients with cytomegalovirus anterior uveitis with corneal endothelial cell damage
title_fullStr	Requirement of longer term antiviral therapy in patients with cytomegalovirus anterior uveitis with corneal endothelial cell damage
title_full_unstemmed	Requirement of longer term antiviral therapy in patients with cytomegalovirus anterior uveitis with corneal endothelial cell damage
title_sort	requirement of longer term antiviral therapy in patients with cytomegalovirus anterior uveitis with corneal endothelial cell damage
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/ec68b07f3f7745d286e05ab50c6b48ee
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Requirement of longer term antiviral therapy in patients with cytomegalovirus anterior uveitis with corneal endothelial cell damage

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