Sheng Qilian, Zhai Ruyi, Fan Xintong, Kong Xiangmei
Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.
National Health Commission Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
Front Med (Lausanne). 2022 Mar 9;9:848820. doi: 10.3389/fmed.2022.848820. eCollection 2022.
To observe and compare the efficacy of 2% ganciclovir eye drops in the treatment of Posner-Schlossman Syndrome relapses with/without cytomegalovirus intraocular reactivation.
A prospective cohort study enrolling 101 patients diagnosed unilateral Posner-Schlossman Syndrome in Eye & ENT hospital, Fudan University, Shanghai, China. Thorough ophthalmic examinations were given. Aqueous humor sample was collected from the attacked eye of each patient and all pathogen immunoglobulins tests were performed. All patients were treated with appropriate corticosteroids and intraocular pressure-lowering drugs. 2% ganciclovir eye drops were given to patients whose cytomegalovirus antibody aqueous humor/serum correction ratio >0. Patients were followed up for 2 months. Ocular manifestations and cumulative drug dose were recorded.
A cytomegalovirus ratio >0.40 was considered cytomegalovirus reactivation. The reactivation group ( = 46) had significantly higher percent of iris depigmentation (78.26%, < 0.05) and endothelial cell loss rate (19.46%, < 0.001) than the latent group ( = 55, 58.18% and 10.86%, respectively). The cumulative treatment time and 2% ganciclovir doses were 6.50 ± 4.67 weeks and 181.70 ± 130.95 drops for the reactivation group; 5.95 ± 4.11 weeks and 161.89 ± 110.66 drops for the latent group ( > 0.05). The median cumulative 2% ganciclovir estimated for inflammation control were 252.00 ± 50.71 and 224.00 ± 32.45 drops for the reactivation and latent group. The residual rate of uncontrolled cases was 0.19 ± 0.15 and 0.00, respectively ( < 0.05).
A treatment course of 8-9 weeks' 2% ganciclovir is recommended to relapses both with and without cytomegalovirus intraocular reactivation. Preventive ganciclovir application may benefit patients with historical cytomegalovirus infections.
www.chictr.org.cn, identifier: ChiCTR1900022340, Date: 2019/04/06.
观察并比较2%更昔洛韦滴眼液治疗伴有/不伴有巨细胞病毒眼内再激活的Posner-Schlossman综合征复发的疗效。
一项前瞻性队列研究，纳入了中国上海复旦大学附属眼耳鼻喉科医院诊断为单侧Posner-Schlossman综合征的101例患者。进行了全面的眼科检查。从每位患者的患眼中采集房水样本，并进行所有病原体免疫球蛋白检测。所有患者均接受了适当的皮质类固醇和降眼压药物治疗。对巨细胞病毒抗体房水/血清校正率>0的患者给予2%更昔洛韦滴眼液。对患者进行了2个月的随访。记录眼部表现和累积药物剂量。
巨细胞病毒比率>0.40被认为是巨细胞病毒再激活。再激活组（n = 46）的虹膜色素脱失百分比（78.26%，P < 0.05）和内皮细胞丢失率（19.46%，P < 0.001）显著高于潜伏组（n = 55，分别为58.18%和10.86%）。再激活组的累积治疗时间和2%更昔洛韦剂量分别为6.50±4.67周和181.70±130.95滴；潜伏组为5.95±4.11周和161.89±110.66滴（P > 0.05）。再激活组和潜伏组控制炎症估计所需的2%更昔洛韦累积中位数分别为252.00±50.71滴和224.00±32.45滴。未控制病例的残留率分别为0.19±0.15和0.00（P < 0.05）。
对于伴有和不伴有巨细胞病毒眼内再激活的复发患者，建议使用2%更昔洛韦进行8 - 9周的疗程治疗。预防性应用更昔洛韦可能对有巨细胞病毒既往感染史的患者有益。
