Glaucoma Associated with Cytomegalovirus Corneal Endotheliitis: Clinical Features

• Thirty-four eyes of 34 patients with CMV corneal endothelitis were enrolled.

• Thirty-two eyes (94.1%) had a history of a glaucoma diagnosis, which had been treated for 10.0 ± 10.1 years.

• Glaucoma in the fellow eye was noted in 16 cases (47.1%) and a history of Posner-Schlossman syndrome was noted in 13 cases (38.2%).

• Visual fields measured using a Humphrey field analyzer were normal-to-early stage (MD>-6dB) in 16 eyes (47.1%) and middle-to-late stage (MD≤-6dB) in 18 eyes (52.9%).

• The intraocular pressure decreased from 22.4 ± 10.6 mmHg at the initial visit to 14.9 ± 7.9 mmHg after medical treatment, including 0.5% topical ganciclovir (GCV) with and without a systemic anti-CMV agent, corticosteroid eye drops, and an anti-glaucoma agent (p<0.01). During the follow-up period of 4.8 ± 3.0 years (range, 0.2–10 years), 16 eyes (47.1%) required glaucoma surgery, including filtering surgery (7 eyes) and trabeculotomy only (9 eyes).><0.01).

• During the follow-up period of 4.8 ± 3.0 years (range, 0.2–10 years), 16 eyes (47.1%) required glaucoma surgery, including filtering surgery (7 eyes) and trabeculotomy only (9 eyes).

"In conclusion, our case series revealed that most of the patients with CMV corneal endotheliitis had glaucoma. Although medical therapy, including 0.5% topical GCV, was effective in reducing the IOP, one-half of the patients required glaucoma surgery. Therefore, ophthalmologists should strive to establish a timely diagnosis of CMV corneal endotheliitis by PCR testing of aqueous humor samples to prevent sight-threatening glaucomatous damage."

Source: Mori et al; Clinical Ophthalmology 2022:16

https://doi.org/10.2147/OPTH.S376039