Long-term results of treatment of the patient with cytomegalovirus anterior uveitis using cyclosporine eye drops in combined therapy

Session Details

Session Title: Infections

Session Date/Time: Sunday 23/09/2018 | 16:30-18:00

Paper Time: 17:36

Venue: Room A3, Podium 3

First Author: : O.Vasilyeva RUSSIA

Co Author(s): :    V. Kurenkov   S. Aksenova                 

Abstract Details

Purpose:

To evaluate the results of a prolonged observation of a patient with cytomegalovirus anterior uveitis for a period of three years, in combined therapy of which cyclosporine eye drops were used.

Setting:

Limited Liability Company «Dr. Kurenkov Clinic», Moscow, Russia Federal State-financed Academic Institution of Higher Education «Ogarev Mordovian State University», Saransk, Russia

Methods:

There was the male patient 28 years old. At the beginning of observations he complained of decreased vision, hallo-effect, feeling of a foreign body in the right eye. In the anamnesis he has three relapses of obscure etiology iridocyclitis within 8months. Objectively: VisOD=0,4sph–0,5D=0,6; OS=1,0; IOP OD=15,OS=16mmHg. OD-Weak conjunctival injection,central rounded surface opacity with a diameter of 3.5mm. From 6to12hours in front stromal layers there was immune ring. On the endothelium there were 15-20 old point precipitates. For aetiological differentiation rheumatological tests and enzyme immunoassay for antibodies to pathogens of slow inejections, in particular, different types of herpes, were performed.

Results:

Rheumatological tests were negative, enzyme immunoassay of blood were negative for antibodies against Toxopl.gondii, Chl.trachomatis and Herpes types, becides anti-CMV IgG antibodies (titer 1:1600). The treatment: a course of anti-CMV therapy every three months (Ganciclovir eye gel 0.15% for 21days, oral Valacyclovir 1000mg 7days, 500mg 14days). Also: Dexamethasone eye drops by decreasing for 12weeks, Cyclosporine 0.05%eye drops twice a day for 12months. Results of one year period: resorption of central opacity and precipitates; incomplete resorption of immune ring, VisOD=1.0;OS=1.0. IOP data was normal. Results of three years period: The cornea is transparent, infiltrates are not detected, no recurrence of iridocyclitis.

Conclusions:

Due to the results of the enzyme immunoassay of blood, namely the positive anti-CMV Ig G ones only, as well as the clinical picture and history, the cytomegalovirus can be known as as a primary reason for the development of anterior uveitis in this case. Long-term combined anti-inflammatory therapy with Cyclosporine 0.05% eye drops and regular anti-CMV courses in patient with recurrent cytomegalovirus anterior uveitis allowed to achieve not only complete cleansing of the cornea, but also stabilization of the inflammatory process in the eye.

Financial Disclosure:

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