Background/aims While cytomegalovirus (CMV) anterior uveitis (AU) patients often require glaucoma surgery, the effectiveness of systemic anti-viral in long-term intraocular pressure (IOP) control is not well established. Our study aims to identify the 2-year efficacy and safety of oral valganciclovir in CMV AU with uncontrolled IOP. Methods In this retrospective case series, one eye from each of 17 immunocompetent PCR-proven patients with CMV AU who received a single course of oral valganciclovir for 20–148 days for medically uncontrolled IOP during 2008–2018 were identified. They were examined at baseline, week 2, months 1, 2 and 3, then every 3 months up to 2 years after commencement of valganciclovir, or until IOP-lowering procedure. Results Median baseline IOP and IOP-lowering medication were 27.0 mm Hg (IQR: 22.9–31.0 mm Hg), and 4.0, respectively. IOP was significantly lower than baseline from 2 weeks to 12 months and at 21 and 24 months after starting valganciclovir (p=0.001 to 0.041, Wilcoxon sign-rank test), with 16.9–46.0% median IOP reduction. Seven (41.2%) and six (35.3%) patients had IOP≤21 mm Hg with same, or reduced, topical medications by 12 and 24 months, respectively. Median time to IOP-lowering intervention or second course of valganciclovir was 12.4 months. There was no serious medication-related adverse event. Common side effects included reduced monocyte count (9 patients) and deranged renal function/electrolytes (5 patients). IOP spike and wound leak occurred in 35.5% and 29.4% of patients, respectively, after diagnostic aqueous tap. Conclusion In CMV AU with uncontrolled IOP, >1/3 of the patients avoided glaucoma surgery over 2 years with a course of oral valganciclovir.

中文翻译：

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口服缬更昔洛韦治疗眼压失控的巨细胞病毒前葡萄膜炎的疗效和安全性

背景/目的虽然巨细胞病毒 (CMV) 前葡萄膜炎 (AU) 患者通常需要进行青光眼手术，但系统性抗病毒药物在长期眼压 (IOP) 控制中的有效性尚未得到充分证实。我们的研究旨在确定口服缬更昔洛韦在眼压未控制的 CMV AU 中的 2 年疗效和安全性。方法 在这个回顾性病例系列中，从 2008 年至 2018 年期间接受单疗程口服缬更昔洛韦 20 至 148 天治疗药物不受控制的眼压的 17 名免疫活性 PCR 证实的 CMV AU 患者的每人中，确定了一只眼睛。他们在基线、第 2 周、第 1 个月、第 2 个月和第 3 个月进行检查，然后在开始使用缬更昔洛韦后每 3 个月至 2 年，或直到降低眼压手术。结果中位基线眼压和降低眼压的药物为 27.0 mm Hg（IQR：22.9–31.0 mm Hg）和 4.0，分别。在开始使用缬更昔洛韦后的 2 周至 12 个月以及 21 和 24 个月，眼压显着低于基线（p=0.001 至 0.041，Wilcoxon 符号秩检验），中位眼压降低 16.9-46.0%。7 名 (41.2%) 和 6 名 (35.3%) 患者的眼压≤21 mm Hg，分别在 12 个月和 24 个月时使用相同或减少的局部药物。降眼压干预或第二个缬更昔洛韦疗程的中位时间为 12.4 个月。没有严重的药物相关不良事件。常见的副作用包括单核细胞计数减少（9 名患者）和肾功能/电解质紊乱（5 名患者）。诊断性水穿刺后，分别有 35.5% 和 29.4% 的患者出现眼压升高和伤口渗漏。结论 在眼压不受控制的 CMV AU 中，>