Neau D, Renaud-Rougier MB, Villard JF, Dutronc H, Cazorla C, Dupon M, Ragnaud JM, Lacut JY; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1998 Sep 24-27; 38: 347 (abstract no. H-112).
Center Hospital University de Bordeaux, France.
Cidofovir is a nucleotide analog with activity against all human herpesviruses. It has been shown to be effective in both initial and salvage therapy of cytomegalovirus (CMV) retinitis. Intraocular inflammation and ocular hypotony have been reported to be a side effect of intravitreous and intravenous cidofovir therapy. We describe fifteen cases of anterior uveitis that occured among patients treated with intravenous cidofovir. Patients and methods. Between March 1997 and April 1998, fifteen patients treated with intravenous cidofovir were monitored by serial ophthalmologic examinations. Twelve were tested for CMV retinitis, two for progressive multifocal leukoencephalopathy (PML), and one for CMV colitis. Cidofovir was administered to all the patients according to the same protocol (5 mg/kg once per week for two weeks, then 5 mg/kg given every two weeks). The drug was discontinued if serum creatinine level increased or persistent proteinuria appeared. An ophthalmologic examination was performed at each infusion. Results. Fifteen cases of anterior uveitis were diagnosed in nine patients treated for CMV retinitis (uveitis recurred in three of the patients). None of the patients treated for PML or CMV colitis had anterior uveitis. Uveitis occurred after 7.6 courses of cidofovir (3- 18). Uveitis was unilateral in 11 cases, bilateral in 4. In every case, only eyes with CMV retinitis were affected. Three patients had ocular hypotony (less than 8 mm Hg) during the bout of uveitis. All patients were treated with a cycloplegic agent and a topical corticosteroid. The inflammation resolved rapidly in every episode. Iridolenticular synechiae persisted in three patients, hindering fundus examination. Cidofovir was continued in all patients. Conclusion. Anterior uveitis appears to be a frequent side effect during intravenous cidofovir therapy for CMV retinitis. It possibly results from an intraocular accumulation of the drug through a breakdown of the blood- occular barrier.
Publication Types:
Keywords:
- Cytomegalovirus Infections
- Cytomegalovirus Retinitis
- Cytosine
- Disease Progression
- Humans
- Leukoencephalopathy, Progressive Multifocal
- Ocular Hypotension
- Phosphonic Acids
- Retinitis
- Uveitis
- Uveitis, Anterior
- cidofovir
- complications
Other ID:
UI: 102188102
From Meeting Abstracts