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[Ocular complications of the virostatic drug cidofovir]
Uwe Hackethal1, Christian Holzapfel, Heinrich Gerding
1Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Münster. hacketu@mednet.uni-muenster.de
Abstract:
Cidofovir, a nucleotide analogue virostatic drug is effective in the treatment of herpes virus infections. However, cytomegaly infection is the prime indication due to its adverse effects. There is growing evidence suggesting cidofovir's effectiveness against progressive multifocal leukoencephalopathy (PML) caused by a reactivation of JC-virus. Chronic ocular hypotension which seems to be therapy refractory and anterior uveitis are considered to be the most serious ocular complications of cidofovir. Secondary side effects such as macular folds, retinal or choroidal detachment can result in a permanent loss of vision. Little is known about the pathology of reduced intraocular pressure and only few reports deal with therapeutical attempts to compensate this complication. Abandoning cidofovir presently remains the only therapeutic option. To avoid serious damage it is of utmost importance to monitor all patients undergoing cidofovir administration for signs of anterior uveitis and ocular hypotension.
Insights
Cidofovir effectively treats herpes virus infections, including progressive multifocal leukoencephalopathy (PML). However, it can cause serious ocular complications like anterior uveitis and ocular hypotension, requiring careful patient monitoring.
Area of Science:
- Ophthalmology
- Virology
- Pharmacology
Background:
- Cidofovir is a nucleotide analogue virostatic drug used for herpes virus infections, particularly cytomegalovirus.
- Emerging evidence supports its use against JC-virus-induced progressive multifocal leukoencephalopathy (PML).
Purpose of the Study:
- To review the serious ocular complications associated with cidofovir treatment.
- To highlight the importance of monitoring for anterior uveitis and ocular hypotension.
Main Methods:
- Literature review of cidofovir's efficacy and adverse effects.
- Analysis of reported ocular complications and therapeutic challenges.
Main Results:
- Cidofovir can lead to refractory ocular hypotension and anterior uveitis.
- These complications can result in vision loss through secondary effects like macular folds or retinal detachment.
- Limited understanding exists regarding the pathology and treatment of cidofovir-induced ocular hypotension.
Conclusions:
- Discontinuation of cidofovir is currently the primary management strategy for ocular complications.
- Vigilant monitoring for anterior uveitis and ocular hypotension is crucial for patients receiving cidofovir to prevent irreversible vision damage.