Document Detail

Anterior uveitis associated with intravenous cidofovir use in patients with cytomegalovirus retinitis.
MedLine Citation:
PMID:  10502577     Owner:  NLM     Status:  MEDLINE    
AIM: Intravenous cidofovir is used to treat cytomegalovirus (CMV) retinitis, and has been reported to cause anterior uveitis. Relations were sought between this complication and patient characteristics that might help predict its occurrence.
METHODS: 17 patients with AIDS and CMV retinitis who were treated with intravenous cidofovir were identified, and the following data collected in a retrospective chart review: demographic characteristics, duration of CMV retinitis, retinal lesion characteristics, dose and duration of cidofovir therapy, tests of renal function, CD4+ T lymphocyte counts, visual acuity, intraocular pressure, iris colour, history of diabetes mellitus, and use of concomitant medications. Case-control analyses were performed to determine risk factors for developing cidofovir associated uveitis.
RESULTS: Anterior uveitis characterised by pain, ciliary injection, and decreased visual acuity occurred in 10 patients (59%). Median interval to development of uveitis was 11 doses of cidofovir. Symptoms developed 4.4 (SD 2.5) days (median 3.5) after an infusion of cidofovir. Patients who developed uveitis had a significantly greater rise in CD4+ T lymphocyte count while receiving cidofovir (68.4 (75.7) x10(6)/l versus 5.0 (0.6) x10(6)/l, (p = 0.04)). By stepwise linear regression, this factor accounted for 33% (p = 0.03) of the effect of developing uveitis. Mean follow up time, intraocular pressure decline during cidofovir therapy, serum creatinine and urine protein concentrations, and rates of protease inhibitor use were not significantly different between patients who developed uveitis and those who did not. Uveitis responded to topical corticosteroids and cycloplegia.
CONCLUSION: Anterior uveitis in patients receiving intravenous cidofovir therapy may be related to improving immune function. The uveitis responds to treatment and may not preclude continuation of cidofovir.
J Ambati; K B Wynne; M C Angerame; M R Robinson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of ophthalmology     Volume:  83     ISSN:  0007-1161     ISO Abbreviation:  Br J Ophthalmol     Publication Date:  1999 Oct 
Date Detail:
Created Date:  2000-01-11     Completed Date:  2000-01-11     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  0421041     Medline TA:  Br J Ophthalmol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1153-8     Citation Subset:  IM; X    
Current address: Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA.
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MeSH Terms
AIDS-Related Opportunistic Infections / drug therapy*
Antiviral Agents / adverse effects*,  therapeutic use
CD4 Lymphocyte Count
Case-Control Studies
Cytomegalovirus Retinitis / drug therapy*
Cytosine / adverse effects,  analogs & derivatives*,  therapeutic use
Middle Aged
Organophosphorus Compounds / adverse effects*,  therapeutic use
Retrospective Studies
Risk Factors
Uveitis, Anterior / chemically induced*,  immunology
Reg. No./Substance:
0/Antiviral Agents; 0/Organophosphonates; 0/Organophosphorus Compounds; 71-30-7/Cytosine; JIL713Q00N/cidofovir
Comment In:
Br J Ophthalmol. 2000 Mar;84(3):233-5   [PMID:  10684829 ]

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