Impact of Reduction of 2% Topical Ganciclovir on Recurrence of Cytomegalovirus Iritis

Ocul Immunol Inflamm. 2025 Jan 13:1-5. doi: 10.1080/09273948.2024.2446417. Online ahead of print.

Abstract

Purpose: To examine the recurrence of cytomegalovirus (CMV) iritis in patients using low-dose ganciclovir (GCV) eye drops.

Methods: We included patients with dormant CMV iritis who were treated using 2% GCV eye drops at the University of Tokyo Hospital between January and June 2023 and whose dosage of GCV eye drops was required to be reduced due to the unstable GCV supply. Patients were excluded if they had active CMV retinitis and underwent corneal transplantation. We examined the recurrence of CMV iritis after the reduction of GCV eye drops.

Results: Fifteen eyes of 14 patients (mean age, 62.4 ± 13.0 years) were included. The frequency of GCV eye drops was reduced from four times a day to twice in 13 eyes and three times in two eyes. The mean observation period after the reduction of GCV eye drops was 202.5 ± 155.8 days. Although there were no recurrences in the 6 months prior to the reduction of GCV eye drops, recurrences were observed in five eyes (33.3%) after the reduction. The mean time from GCV reduction to recurrence was 59.2 ± 11.3 days. Patients who survived the first 3 months without recurrence had no recurrence later.

Conclusion: Recurrences of CMV iritis were observed in one-third of the eyes within 3 months after dosage reduction of 2% GCV eye drops.

Keywords: Cytomegalovirus; ganciclovir; immunosuppressant; ocular inflammation; uveitis.