Topical ganciclovir treatment in patients with cytomegalovirus endotheliitis receiving penetrating keratoplasty

Abstract

Continuous topical 2% ganciclovir and a topical steroid adjusted by anterior inflammation are suggested after penetrating keratoplasty in all cases with cytomegalovirus endotheliitis to prevent cytomegalovirus recurrence.

Clinical Outcomes in Cytomegalovirus-Positive Posner-Schlossman Syndrome Patients Treated With Topical Ganciclovir Therapy

“…10 The treatment was applied every 2 to 3 hours daily as an induction therapy, and every 4 hours as a long-term maintenance therapy, as previously reported. 10 After the continual administration of topical ganciclovir for 3 months, all patients underwent another aqueous humor tap to perform a PCR test for detecting the presence of CMV. Topical ganciclovir was prescribed as a long-term antiviral therapy, without discontinuation.…”

“…[1][2]17 In our daily practice, we use topical 2% ganciclovir as a long-term maintenance therapy without interruption for Posner-Schlossman syndrome patients with CMV-positive eyes. 10 Until now, no large-scale study of the long-term clinical outcomes in CMV-positive Posner-Schlossman syndrome patients has been reported. The In this report, we investigated the efficacy of a topical ganciclovir treatment on CMV-related Posner-Schlossman syndrome.…”

“…8 Continual administration of ganciclovir was considered to control the reactivation of CMV in an immunocompetent group. [8][9][10] In our previous report, we determined that topical administration of 2% ganciclovir eye drops could effectively clear the viral load in CMV endotheliitis. 10 A continual topical ganciclovir treatment avoids the side effects of long-term systemic and intravitreal ganciclovir treatments, including pancytopenia, renal impairment, retinal detachment, and endophthalmitis.…”

“…[8][9][10] In our previous report, we determined that topical administration of 2% ganciclovir eye drops could effectively clear the viral load in CMV endotheliitis. 10 A continual topical ganciclovir treatment avoids the side effects of long-term systemic and intravitreal ganciclovir treatments, including pancytopenia, renal impairment, retinal detachment, and endophthalmitis. [11][12][13] In the literature, induction therapy for CMV infection included the systemic administration of ganciclovir and valganciclovir, 1-2, 5, 9, 14-17 and the intravitreal injection of ganciclovir.…”

Topical ganciclovir treatment post-Descemet’s stripping automated endothelial keratoplasty for patients with bullous keratopathy induced by cytomegalovirus

“…It has previously been reported that GCV is effective in eliminating the CMV viral antigen, maintaining the control of IOP and preventing CEC loss in cases of CMV-positive PSS 16. It has also been reported that in patients with CMV endotheliitis who undergo corneal transplantation surgery, the postoperative recurrence of CMV is a serious complication that can lead to intractable graft failure 9. For patients suffering from corneal endothelial disease, DSAEK has now become the ‘treatment of choice’ to reduce graft rejection and long-term postoperative PKP-related complications.…”