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John Wong, Stephen C B Teoh; Outcomes of Ganciclovir 0.15% Ointment use in patients with Cytomegalovirus(CMV)-related anterior uveitis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6291.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the outcomes of treatment of CMV anterior uveitis patients with 0.15% ganciclovir ointment.
Retrospective review of the disease course in 31 patients (33 eyes) with positive aqueous polymerase-chain-reaction (PCR) for CMV, with 160 episodes of anterior uveitis flare dating from December 1992 to December 2012. All patients were treated with concomitant anti-inflammatory eyedrops. Intra-eye comparison was made for the disease course and recurrence rate, before and after ganciclovir ointment was started.
The mean age at first presentation of uveitis in these patients was 57.5 (±12.6) years old. 28 patients (90.3%) are Chinese. Compared to without ganciclovir use, patients on ganciclovir ointment had a statistically significant fewer number of episodes of uveitis flare per person year (median -0.88 episodes/PY, p=0.029). The time to quiescence was not significantly affected by ganciclovir ointment use (median-1.25 days, p=0.610). In the survival analysis using the Cox regression model, topical ganciclovir use was associated with a lower risk of recurrence but this was not statistically significant (hazard ratio = 0.857, 95% C.I : 0.543 - 1.36, p = 0.511). Overall median time to recurrence was 290 days (95% C.I: 113 to 274 days) and 164 days (125 to 404 days)(p=0.492), with and without ganciclovir use, respectively.
Our results suggests that the use of 0.15% ganciclovir ointment significantly reduces the number of episodes of uveitis recurrence and is associated with prolonging the time to recurrence. The time-to-quiescence is not significantly affected by ganciclovir ointment use. Prospective studies with a larger number of patients are required to verify our findings.
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