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Topical ganciclovir treatment in patients with cytomegalovirus endotheliitis receiving penetrating keratoplasty.

Publication ,  Journal Article
Su, C-C; Wang, I-J; Chen, W-L; Lin, C-P; His, B; Hu, F-R
Published in: Clin Exp Ophthalmol
2013

BACKGROUND: To report seven cases diagnosed as cytomegalovirus endotheliitis and treated with topical 2% ganciclovir following penetrating keratoplasty. DESIGN: A retrospectively comparative case series. PARTICIPANTS: A retrospective interventional case series, including seven eyes of seven patients with cytomegalovirus endotheliitis after penetrating keratoplasty. METHODS: Clinical and immunological characteristics were studied in seven penetrating keratoplasty cases with positive quantitative polymerase chain reaction results for cytomegalovirus DNA from aqueous taps and treated with topical 2% ganciclovir. MAIN OUTCOME MEASURES: Clinical features and responses to topical 2% ganciclovir. RESULTS: Seven immunocompetent patients experienced acute anterior inflammation with graft oedema and pigmented keratic precipitates after penetrating keratoplasty. Their immunological profiles showed immunoglobulin G cytomegalovirus (+) and immunoglobulin M cytomegalovirus (-) in all cases. Topical 2% ganciclovir was prescribed every 2 to 3 h daily as induction therapy and every 4 h as long-term maintenance therapy. All cases had undetectable cytomegalovirus DNA after follow-up aqueous taps. Topical 2% ganciclovir preserved endothelium of cytomegalovirus-infected grafts at early stage and also provided a steady anticytomegalovirus environment for further regrafting in failed grafts at late stage. Acute inflammation reactivated in two cases and was suppressible by steroid under topical ganciclovir. No delayed re-epithelialization and any toxicity were observed. To date, no case treated in this way had displayed cytomegalovirus recurrence. CONCLUSIONS: Continuous topical 2% ganciclovir and a topical steroid adjusted by anterior inflammation are suggested after penetrating keratoplasty in all cases with cytomegalovirus endotheliitis to prevent cytomegalovirus recurrence.

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Published In

Clin Exp Ophthalmol

DOI

EISSN

1442-9071

Publication Date

2013

Volume

41

Issue

4

Start / End Page

339 / 347

Location

Australia

Related Subject Headings

  • Retrospective Studies
  • Real-Time Polymerase Chain Reaction
  • Postoperative Complications
  • Ophthalmology & Optometry
  • Middle Aged
  • Male
  • Keratoplasty, Penetrating
  • Keratitis
  • Humans
  • Graft Survival
 

Citation

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Chicago
ICMJE
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Su, C.-C., Wang, I.-J., Chen, W.-L., Lin, C.-P., His, B., & Hu, F.-R. (2013). Topical ganciclovir treatment in patients with cytomegalovirus endotheliitis receiving penetrating keratoplasty. Clin Exp Ophthalmol, 41(4), 339–347. https://doi.org/10.1111/j.1442-9071.2012.02888.x
Su, Chien-Chia, I-Jong Wang, Wei-Li Chen, Chang-Pin Lin, Brian His, and Fung-Rong Hu. “Topical ganciclovir treatment in patients with cytomegalovirus endotheliitis receiving penetrating keratoplasty.Clin Exp Ophthalmol 41, no. 4 (2013): 339–47. https://doi.org/10.1111/j.1442-9071.2012.02888.x.
Su C-C, Wang I-J, Chen W-L, Lin C-P, His B, Hu F-R. Topical ganciclovir treatment in patients with cytomegalovirus endotheliitis receiving penetrating keratoplasty. Clin Exp Ophthalmol. 2013;41(4):339–47.
Su, Chien-Chia, et al. “Topical ganciclovir treatment in patients with cytomegalovirus endotheliitis receiving penetrating keratoplasty.Clin Exp Ophthalmol, vol. 41, no. 4, 2013, pp. 339–47. Pubmed, doi:10.1111/j.1442-9071.2012.02888.x.
Su C-C, Wang I-J, Chen W-L, Lin C-P, His B, Hu F-R. Topical ganciclovir treatment in patients with cytomegalovirus endotheliitis receiving penetrating keratoplasty. Clin Exp Ophthalmol. 2013;41(4):339–347.
Journal cover image

Published In

Clin Exp Ophthalmol

DOI

EISSN

1442-9071

Publication Date

2013

Volume

41

Issue

4

Start / End Page

339 / 347

Location

Australia

Related Subject Headings

  • Retrospective Studies
  • Real-Time Polymerase Chain Reaction
  • Postoperative Complications
  • Ophthalmology & Optometry
  • Middle Aged
  • Male
  • Keratoplasty, Penetrating
  • Keratitis
  • Humans
  • Graft Survival