Cytomegalovirus-associated anterior segment infection

Abstract

Cytomegalovirus (CMV) has increasingly been found as a cause of anterior segment infection in immunocompetent patients. This may manifest as an endotheliitis or as an acute episodic or chronic recurrent anterior uveitis, which is often associated with ocular hypertension. Its diagnosis is based on aqueous analysis for CMV DNA by PCR or for CMV-specific antibodies. Although it has a high response rate to systemic, intravitreal and ganciclovir implant, the relapse rate is also high, and patients may require prolonged treatment. Topical ganciclovir gel has a lower response rate but also a lower relapse rate and fewer adverse effects. The main cause of visual loss in CMV anterior uveitis is glaucoma, and endothelial failure in endotheliitis. Therefore, early diagnosis and treatment is vital, and glaucoma therapy is an important adjunctive modality of management. © 2011 Expert Reviews Ltd.