A therapeutic trial of valganciclovir in patients with uveitis and positive Epstein-Barr virus early antigen D IgG titers.
OBJECTIVE
To evaluate the effectiveness of a therapeutic trial of valganciclovir in patients with uveitis with positive Epstein-Barr virus early antigen D immunoglobulin G titers (EBV EA-D).


METHODS
We performed a retrospective chart review of 14 patients at the Massachusetts Eye Research and Surgery Institution who had uveitis with positive EBV EA-D but negative studies for all other causes of uveitis and were treated with valganciclovir 450 mg twice a day or valganciclovir 900 mg twice a day between January 2010 and August 2014.


RESULTS
Nine of 14 patients, who had presumed EBV reactivation with associated intraocular inflammation, were successfully treated with valganciclovir: 3 of these were treated with valganciclovir 450 mg twice a day and 6 were treated with valganciclovir 900 mg twice a day. Five of 14 patients failed to respond to valganciclovir with persistent inflammation after at least 2 weeks of valganciclovir therapy, and were subsequently treated with immunomodulatory therapy to control inflammation.


CONCLUSIONS
Uveitis can be caused by EBV infection/reactivation. A therapeutic trial with valganciclovir 450 mg twice a day for 1 month in patients with uveitis with positive EBV EA antibody may be beneficial.
Massachusetts Eye Research and Surgery Institution, Waltham, MA - USA.|Department of Ophthalmology, Siriraj Hospital, Mahidol University, Bangkok - Thailand.
Sutasinee
S
Boonsopon
Massachusetts Eye Research and Surgery Institution, Waltham, MA - USA.|Ocular Immunology and Uveitis Foundation, Waltham, MA - USA.
Armin
A
Maghsoudlou
Massachusetts Eye Research and Surgery Institution, Waltham, MA - USA.|Ocular Immunology and Uveitis Foundation, Waltham, MA - USA.|Yale School of Medicine, New Haven, CT - USA.
Ninani E
NE
Kombo
Massachusetts Eye Research and Surgery Institution, Waltham, MA - USA.|Ocular Immunology and Uveitis Foundation, Waltham, MA - USA.|Harvard Medical School, Boston, MA - USA.
C Stephen
CS
Foster
D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000276:immunology*; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D020031:Epstein-Barr Virus Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D015828:Eye Infections, Viral / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D005260:Female; D015774:Ganciclovir / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D014605:Uveitis / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D000077562:Valganciclovir
D000914:Antibodies, Viral; D000956:Antigens, Viral; D000998:Antiviral Agents; C083204:Epstein-Barr virus early antigen diffuse component; D007074:Immunoglobulin G; D000077562:Valganciclovir; D015774:Ganciclovir