Ocular side-effects from systemic HPMPC (Cidofovir) for a non-ocular cytomegalovirus infection.
OBJECTIVE
To report a case of anterior uveitis and ocular hypotony during HPMPC treatment of a cytomegalovirus infection without ophthalmic involvement.


METHODS
A 61-year-old bisexual white man with AIDS presented with moderate anterior uveitis and ocular hypotony after 8 weeks of intravenous HPMPC and oral probenecid co-treatment of a presumed recurrence of cytomegalovirus encephalitis.


RESULTS
There was no evidence of an ocular cytomegalovirus infection. Cidofovir-related uveitis was diagnosed, and the HPMPC-probenecid co-treatment was switched to ganciclovir monotherapy. The ocular inflammation was successfully managed with topical steroids and mydriatics.


CONCLUSIONS
This description of ophthalmic side effects from systemic HPMPC in the absence of ocular cytomegalovirus infection supports the hypothesis that anterior uveitis and ocular hypotony result from a direct interaction between the drug and the ciliary body.
Scott
R A
RA
Moorfields Eye Hospital, London, United Kingdom. rob.scott@lineone.net
Pavesio
C
C
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000077404:Cidofovir; D003586:Cytomegalovirus Infections / Q000188:drug therapy*; D003596:Cytosine / Q000009:adverse effects* / Q000031:analogs & derivatives / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000139:chemically induced*; D063065:Organophosphonates; D009943:Organophosphorus Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D011339:Probenecid / Q000627:therapeutic use; D014606:Uveitis, Anterior / Q000139:chemically induced*
D000998:Antiviral Agents; D063065:Organophosphonates; D009943:Organophosphorus Compounds; D003596:Cytosine; D000077404:Cidofovir; D011339:Probenecid