title: Clinical outcomes in cytomegalovirus-positive Posner-Schlossman syndrome patients treated with topical ganciclovir therapy.
abstract: OBJECTIVE
  To evaluate the clinical characteristics and therapeutic outcomes of cytomegalovirus (CMV)-positive Posner-Schlossman syndrome patients undergoing topical ganciclovir treatment.
  
  
  METHODS
  Retrospective, comparative, and interventional case series.
  
  
  METHODS
  One eye of each of 126 consecutive Posner-Schlossman syndrome patients was investigated using aqueous polymerase chain reaction (PCR) between January 2006 and June 2013. The initial presentations and follow-up data of the CMV-positive patients (68 eyes) and CMV-negative patients (58 eyes) were compared.
  
  
  RESULTS
  Severe endothelial cell loss (P < .001) and a higher number of eyes requiring glaucoma filtering surgery (P = .017) were observed in CMV-positive Posner-Schlossman syndrome patients. All CMV-infected eyes treated with continual topical 2% ganciclovir exhibited an undetectable CMV level at the following taps. During follow-up, the average number of antiglaucomatous agents decreased, and a similar frequency of intraocular pressure (IOP) spikes was observed in both groups (P = .358). Patients with CMV-positive eyes with a disease duration over 5 years were likely to require glaucoma surgery (P = .024, log-rank test). All patients receiving surgery exhibited CMV-negative PCR during the IOP attack, but experienced severe peripheral anterior synechiae and pigment clogging. Both groups exhibited a similar endothelial cell decrease (P = .243) and probability of progressive endothelial cell loss (P = .219, log-rank test).
  
  
  CONCLUSIONS
  Ganciclovir treatment was effective for clearing the viral load, assisting the IOP control, and preserving the corneal endothelium of CMV-positive Posner-Schlossman syndrome patients. Early diagnosis and proper treatment could decrease the risk of advanced glaucoma and avoid glaucoma surgery in long-lasting cases.
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan; Department of Ophthalmology, National Taiwan University Hospital College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Chien-Chia
authors.initials: CC
authors.lastname: Su
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital College of Medicine, National Taiwan University, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Fung-Rong
authors.initials: FR
authors.lastname: Hu
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital College of Medicine, National Taiwan University, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Tsing-Hong
authors.initials: TH
authors.lastname: Wang
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital College of Medicine, National Taiwan University, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Jehn-Yu
authors.initials: JY
authors.lastname: Huang
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital College of Medicine, National Taiwan University, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Po-Ting
authors.initials: PT
authors.lastname: Yeh
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital College of Medicine, National Taiwan University, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Chang-Ping
authors.initials: CP
authors.lastname: Lin
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital College of Medicine, National Taiwan University, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan. Electronic address: ijong@ms8.hinet.net.
authors.forename: I-Jong
authors.initials: IJ
authors.lastname: Wang
mesh_terms: D000287:Administration, Topical; D000998:Antiviral Agents / Q000008:administration & dosage; D001082:Aqueous Humor / Q000821:virology; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000382:microbiology; D004279:DNA, Viral / Q000032:analysis; D015828:Eye Infections, Viral / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D015774:Ganciclovir / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D013577:Syndrome; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D015774:Ganciclovir