The effect of topical ganciclovir and corticosteroid on cytomegalovirus corneal endotheliitis in Korean patients

Session Details

Session Title: Presented Poster Session: Cornea: Medical

Venue: Poster Village: Pod 2

First Author: : R.Yi SOUTH KOREA

Co Author(s): :    J. Oh   S. Chung   J. Hwang                 

Abstract Details

Purpose:

To report long-term outcomes of topical ganciclovir (GCV) and corticosteroids in Korean patients with cytomegalovirus(CMV) corneal endotheliitis.

Setting:

1Department of Ophthalmology Sanggye Paik Hospital, Inje University of Korea, College of Medicine, Seoul, Republic of Korea 2Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, Catholic Institute for Visual Science, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea

Methods:

This retrospective study included 13 eyes of 13 patients with CMV corneal endotheliitis with a minimum 12-month follow-up. CMV corneal endotheliitis was diagnosed by typical clinical manifestations and CMV polymerase chain reaction (PCR) of aqueous humor. The patients were persistently treated with topical 2% GCV and 1% prednisolone acetate (Pred Forte, Allergan®) eyedrop. Clinical evaluations and specular microscopy were measured during treatment period. The mean follow-up period was 24.5 ± 8.2 months. All patients demonstrated unilateral typical coin-shaped keratic precipitates or linear KP, and positive CMV PCR of aqueous humor.

Results:

9patients showed anterior chamber inflammation and 11patients demonstrated corneal edema. Within 2weeks, all patients showed decreased KPs, anterior chamber reactions or corneal edema after topical 2% GCV every 2 hours and 1% prednisolone acetate 4times a day. All 13eyes had a clear cornea or graft at the end of study and the mean endothelial cell density showed no significant change compared to the baseline. During follow up, 4 patients developed mild anterior chamber inflammation with increased IOP without typical coin-shaped KPs or edema. 1patient showed a recurrence of corneal edema twice and used systemic valgancyclovir for 2weeks on 2nd recurrence.

Conclusions:

Long-term maintenance therapy with topical 2% GCV and corticosteroid was proven to be effective to treat CMV endotheliitis and maintain corneal endothelial function in Korean patients.

Financial Disclosure:

None