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[Anterior uveitis and cidofovir]
M B Rougier1, D Neau, J F Viallard
1Service d'Ophtalmologie, Centre Hospitalier Universitaire, Hôpital Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux Cedex.
Purpose:
This retrospective study was designed to determine the different parameters involved in the occurrence of uveitis during treatment with codofovir.
Patients And Methods:
This study included 10 patients out of 13 treated with cidofovir for cytomegalovirus (CMV) disease. Ocular examination, CD4+ lymphocyte count, and creatinine clearance were performed for each case of uveitis.
Results:
During the 17-month study, 20 uveitis cases were analyzed. The first attack occurred after a median interval of 7.6 doses. At the time of ocular inflammation, 65% of the cases had a CD4+ lymphocyte count >=100x10(6)/L, the patients thus had an improved immune function. Half of the patients had a normal creatinine clearance. The patients with a CD4+ lymphocyte count<100x10(6)/L who presented one or more incidents of uveitis had an abnormal clearance, thus probably inducing intraocular storage of the drug.
Conclusion:
The occurrence of anterior uveitis during treatment with cidofovir is induced by the association of several parameters: a previous history of CMV retinitis, improvement of the immune function state, and intraocular storage of the drug.