Cytomegalovirus (CMV) can manifest as corneal endotheliitis in immunocompetent individuals. Early diagnosis is prudent to prevent endothelial cell loss, which could ultimately lead to corneal decompensation. CMV DNA was first detected in an eye with corneal endotheliitis in 2006; since then, clinical evidence from numerous case reports and case series have accumulated. In this narrative review, we identified several drugs, including ganciclovir, valganciclovir, and their combination in oral, intravenous, intravitreal, and topical forms in different concentrations, together with the judicious use of topical steroids, have reported variable success. There has yet to be any prospective comparative study evaluating the efficacy and safety of these assorted forms of treatment; clinical evidence is based on case reports and case series. CMV endotheliitis presenting with corneal edema can masquerade as other corneal diseases and thus poses a great challenge especially in post-keratoplasty eyes. Heightened awareness is needed before and after keratoplasty to start prompt prophylaxis and treatment. There is no consensus on the management of CMV endotheliitis. Further studies are much needed to elucidate the optimal treatment modality, regime, and duration in the treatment and prophylaxis of CMV endotheliitis.

中文翻译：

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巨细胞病毒角膜内皮炎的治疗

巨细胞病毒 (CMV) 可在免疫功能正常的个体中表现为角膜内皮炎。早期诊断是谨慎的，以防止内皮细胞丢失，这最终可能导致角膜失代偿。2006 年，在患有角膜内皮炎的眼睛中首次检测到 CMV DNA；从那时起，积累了大量病例报告和病例系列的临床证据。在这篇叙述性综述中，我们确定了几种药物，包括更昔洛韦、缬更昔洛韦，以及它们在不同浓度的口服、静脉注射、玻璃体内和局部形式的组合，以及明智地使用局部类固醇，都取得了不同程度的成功。目前还没有任何前瞻性比较研究评估这些治疗形式的有效性和安全性；临床证据基于病例报告和病例系列。表现为角膜水肿的 CMV 内皮炎可以伪装成其他角膜疾病，因此对角膜移植术后的眼睛来说是一个巨大的挑战。角膜移植术前后需要提高认识，以开始及时的预防和治疗。关于 CMV 内皮炎的治疗尚无共识。需要进一步的研究来阐明治疗和预防 CMV 内皮炎的最佳治疗方式、方案和持续时间。