title: Long-Term Topical Ganciclovir and Corticosteroids Preserve Corneal Endothelial Function in Cytomegalovirus Corneal Endotheliitis.
abstract: OBJECTIVE
  To report the long-term outcomes of topical ganciclovir (GCV) and corticosteroids as a maintenance therapy for cytomegalovirus (CMV) corneal endotheliitis.
  
  
  METHODS
  This retrospective study included 10 eyes of 9 patients diagnosed with CMV corneal endotheliitis with a minimum 1-year follow-up at a tertiary referral hospital between 2008 and 2014. CMV corneal endotheliitis was defined by corneal edema associated with typical keratic precipitates (KPs) and a positive CMV polymerase chain reaction from aqueous humor taps. Patients receiving long-term topical 0.5% GCV and topical corticosteroids without discontinuation were included. The final corneal condition and endothelial cell density (ECD) were reported.
  
  
  RESULTS
  The mean age was 45.6 ± 11.7 years. The mean follow-up duration was 48 ± 25 months. All patients exhibited typical coin-shaped and/or linear KPs. A significant resolution of corneal edema and decreased KPs were achieved within 1 month in all patients after initiating topical 0.5% GCV every 2 hours and topical corticosteroids twice a day. The dose frequency was gradually tapered to GCV 4 times and corticosteroids once or twice a day as a maintenance therapy. All 10 eyes had a clear graft or corneas at the end of this study. The mean ECD was 1630 ± 699 cells per millimeter square before treatment and 1776 ± 834 cells per millimeter square at the end of the study period.
  
  
  CONCLUSIONS
  Topical 0.5% GCV and corticosteroids as a maintenance regimen without interruption effectively preserved long-term corneal endothelial function.
authors.affiliation: *Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan;†Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan;‡National Yang-Ming University School of Medicine, Taipei, Taiwan;§Department of Medicine of Yang-Ming Branch, Taipei City Hospital, Taipei, Taiwan; and¶Division of Haematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Nai-Wen
authors.initials: NW
authors.lastname: Fan
authors.forename: Yu-Chien
authors.initials: YC
authors.lastname: Chung
authors.forename: Yao-Chung
authors.initials: YC
authors.lastname: Liu
authors.forename: Catherine Jui-Ling
authors.initials: CJ
authors.lastname: Liu
authors.forename: Yih-Shiuan
authors.initials: YS
authors.lastname: Kuo
authors.forename: Pei-Yu
authors.initials: PY
authors.lastname: Lin
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001082:Aqueous Humor / Q000821:virology; D015715:Corneal Edema / Q000188:drug therapy / Q000503:physiopathology / Q000821:virology; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology; D004279:DNA, Viral / Q000235:genetics; D004338:Drug Combinations; D004728:Endothelium, Corneal / Q000502:physiology*; D015828:Eye Infections, Viral / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D015774:Ganciclovir / Q000008:administration & dosage / Q000627:therapeutic use*; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007634:Keratitis / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D016133:Polymerase Chain Reaction; D011239:Prednisolone / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D004338:Drug Combinations; D005938:Glucocorticoids; D009883:Ophthalmic Solutions; C009935:prednisolone acetate; D011239:Prednisolone; D015774:Ganciclovir