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Ninani Kombo, C Stephen Foster; Experience with valganciclovir in the treatment of presumed Epstein - Barr Virus (EBV)-associated uveitis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2838.
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To describe the outcomes of oral valganciclovir treatment in patients with intraocular inflammation in the setting of elevated EBV antibodies directed against antigen D.
A chart review of all patients seen at the Massachusetts Eye Research and Surgery Institution (MERSI) between 2010 and 2013 with uveitis and concurrent elevated antibody titers to Epstein - Barr Virus (including antigen D), but negative studies for other causes of uveitis who were treated with valganciclovir was performed. Eleven patients were identified.
15 eyes of eleven patients had uveitis. All patients were positive for the EBV early antigen D antibody. The average age of presentation was 44.6 years (range 21 to 66 years). 13 of the 15 eyes no longer had uveitis after an average of 1.67 months (range 3 weeks to 4 months) of valganciclovir treatment. 2 eyes of one patient with retinal vasculitis which showed marked improvement over 10 months with continued therapy. The types of inflammation observed were endotheliitis (1 patient), anterior (3 patients) and anterior and intermediate uveitis (2 patients), intermediate uveitis (1 patient), vasculitis (3 patients) and panuveitis (1 patient). One patient is on continued therapy. 10 of the patients have steroid free remission with a mean follow-up of 4.9 months (range 1 to 12 months). There have been no relapses of uveitis. The treatment duration ranged from 3 weeks to 18 months. Seven patients were treated with 900mg twice a day and 4 patients had 450mg twice a day. There were no hematologic or other adverse events observed in these patients.
Patients who present with uveitis and positive Epstein - Barr virus serology for early antigen D may benefit from a therapeutic trial of valganciclovir.
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