J Korean Ophthalmol Soc.  2016 Jun;57(6):863-875. 10.3341/jkos.2016.57.6.863.

Clinical Manifestations and Outcomes of Treatment in Cytomegalovirus Endotheliitis

Affiliations
  • 1Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea. Maya12kim@naver.com
  • 2Lee Seong Su Eye Center, Jinju, Korea.
  • 3Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, Korea.
  • 4Department of Laboratory Medicine, Gyeongsang National University College of Medicine, Jinju, Korea.

Abstract

PURPOSE
To elucidate the clinical manifestations of cytomegalovirus (CMV) endotheliitis, and evaluate the outcomes of treatment in CMV endotheliitis.
METHODS
We reviewed the medical records of 7 patients (8 eyes) who were diagnosed with CMV endotheliitis via a polymerase chain reaction (PCR) of aqueous humor and were treated with ganciclovir.
RESULTS
Eight eyes of 7 patients were followed for a mean of 17.8 months. One patient had bilateral corneal endotheliitis. All eyes had coin-shaped keratoprecipitates and mild anterior chamber inflammation (1+~2+). All eyes had an absence of anterior segment inflammation 3 weeks after ganciclovir treatment. Following treatment, the mean visual acuity improved significantly from 0.60 ± 0.40 (log MAR) at baseline to 0.18 ± 0.18 (log MAR) at last follow-up. The mean intraocular pressure (IOP) decreased significantly from 30 mm Hg at baseline to 12 mm Hg at last visit. Two eyes had a recurrence of corneal endotheliitis, where one underwent penetrating keratoplasty and the other was treated with intravitreal ganciclovir injection.
CONCLUSIONS
Patients with increased IOP and coin-shaped keratoprecipitates are suspected to have CMV endotheliitis, and PCR of aqueous humor is needed to diagnose CMV endotheliitis. More than 6 weeks of ganciclovir treatment might be effective for CMV endotheliitis and may help prevent recurrence.

Keyword

Cytomegalovirus; Endotheliitis; Ganciclovir

MeSH Terms

Anterior Chamber
Aqueous Humor
Cytomegalovirus*
Follow-Up Studies
Ganciclovir
Humans
Inflammation
Intraocular Pressure
Keratoplasty, Penetrating
Medical Records
Polymerase Chain Reaction
Recurrence
Visual Acuity
Ganciclovir
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