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2%更昔洛韦滴眼液治疗巨细胞病毒性前葡萄膜炎的疗效

Efficacy of 2% ganciclovir eye drops in the treatment of cytomegalovirus anterior uveitis.

作者信息

Yoneda Yu, Takenaka Yuki, Taniguchi Nanae, Yoneda Keisuke, Seki Kyosuke, Oyama Tomoyuki, Imazeki Masaya, Takeuchi Masaru

机构信息

Department of Ophthalmology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.

出版信息

Jpn J Ophthalmol. 2025 Aug 9. doi: 10.1007/s10384-025-01250-y.

Abstract

PURPOSE

To investigate the efficacy and safety of 2% ganciclovir (GCV) eye drops for the treatment of primary cytomegalovirus anterior uveitis (CMV-AU) STUDY DESIGN: Retrospective cohort study METHODS: This study included 12 patients diagnosed with CMV-AU who were treated with 2% GCV eye drops. The patients' demographics, clinical presentations, treatment regimens, and outcomes were analyzed.

RESULTS

The cohort consisted predominantly of men (11:1 ratio), with a mean age of 63.4 years and all presenting with unilateral disease. Common presenting symptoms were blurred vision and elevated intraocular pressure (IOP). After the initiation of 2% GCV eye drops, all the patients demonstrated positive responses, with improvement in BCVA, decreased IOP, and resolution of keratic precipitates including coin-shaped lesions. Recurrence of uveitis occurred in 66.7% of the patients and was managed with intensified topical corticosteroids, antiglaucoma medications, and/or short-term oral GCV. IOP significantly decreased after treatment (P <.05), whilst BCVA and corneal endothelial cell counts remained stable. No patients developed bullous keratopathy or required intravenous GCV. One patient underwent trabeculectomy for uncontrolled IOP.

CONCLUSION

This study's findings suggest that 2% GCV eye drops are a safe and effective treatment option for primary CMV-AU, offering improvements in IOP and uveitis control. All the patients completed the treatment without serious adverse events, supporting the favorable safety profile of 2% GCV eye drops.

摘要

目的

探讨2%更昔洛韦(GCV)滴眼液治疗原发性巨细胞病毒性前葡萄膜炎(CMV-AU)的疗效和安全性。

研究设计

回顾性队列研究。

方法

本研究纳入12例诊断为CMV-AU并接受2% GCV滴眼液治疗的患者。分析患者的人口统计学特征、临床表现、治疗方案和结局。

结果

该队列主要为男性(比例为11:1),平均年龄63.4岁,均为单眼患病。常见的临床表现为视力模糊和眼压(IOP)升高。开始使用2% GCV滴眼液后,所有患者均表现出阳性反应,最佳矫正视力(BCVA)改善,IOP降低,角膜后沉着物包括钱币状病变消退。66.7%的患者葡萄膜炎复发,通过强化局部使用糖皮质激素、抗青光眼药物和/或短期口服GCV进行处理。治疗后IOP显著降低(P<.05),而BCVA和角膜内皮细胞计数保持稳定。无患者发生大疱性角膜病变或需要静脉使用GCV。1例患者因IOP控制不佳接受了小梁切除术。

结论

本研究结果表明,2% GCV滴眼液是治疗原发性CMV-AU的一种安全有效的治疗选择,可改善IOP并控制葡萄膜炎。所有患者均完成治疗,无严重不良事件,支持2% GCV滴眼液良好的安全性。

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