Anterior uveitis and hypotony after intravenous cidofovir for the treatment of cytomegalovirus retinitis.
OBJECTIVE
This study aimed to describe the incidence and risk factors for the development of anterior uveitis in patients receiving intravenous cidofovir for the treatment of longstanding cytomegalovirus retinitis.


METHODS
The study design was a retrospective cohort.


METHODS
Eighteen patients (30 eyes) receiving parenteral cidofovir for the treatment of complicated cytomegalovirus retinitis participated.


METHODS
The clinical response to parenteral cidofovir; the occurrence of anterior uveitis, and the management and outcome of patients with this complication; and the effect of cidofovir on intraocular pressure measurements were measured.


RESULTS
There was no progression or relapse of retinitis in patients receiving intravenous cidofovir. Eight (44%) of the 18 patients developed anterior uveitis, which occurred after a median of 4 doses of intravenous cidofovir. The median CD4+ cell count at the time of development of iritis was 101/mm3. Patients who developed uveitis had a mean increase in serum creatinine over baseline measurements (P = 0.05). The use of human immunodeficiency virus type-1 (HIV-1) protease inhibitors was not different between both groups of patients (P = 1.0). The development of anterior uveitis and visually significant hypotony necessitated withdrawal of cidofovir in only one patient.


CONCLUSIONS
Anterior uveitis was a common complication after intravenous cidofovir therapy. Despite the frequency of this complication, continued treatment with intravenous cidofovir was possible in the majority of patients. Patients with anterior uveitis after intravenous cidofovir may be treated successfully with topical corticosteroid therapy and cycloplegic agents.
Akler
M E
ME
Department of Ophthalmology, University of Colorado Health Sciences Center, Denver 80262, USA.
Johnson
D W
DW
Burman
W J
WJ
Johnson
S C
SC
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D000077404:Cidofovir; D015331:Cohort Studies; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy*; D003596:Cytosine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015994:Incidence; D007275:Injections, Intravenous; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000139:chemically induced* / Q000473:pathology; D063065:Organophosphonates; D009943:Organophosphorus Compounds / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014606:Uveitis, Anterior / Q000139:chemically induced* / Q000473:pathology
D000998:Antiviral Agents; D063065:Organophosphonates; D009943:Organophosphorus Compounds; D003596:Cytosine; D000077404:Cidofovir