Long-Term Outcomes of a Standardized 12-Week Oral Valganciclovir Treatment for PCR-Proven CMV Anterior Uveitis: A...

To evaluate the outcomes of a standardized 12-week oral valganciclovir regimen in Korean patients with CMV anterior uveitis and to identify predictors of recurrence.

Eighteen eyes with PCR-confirmed CMV anterior uveitis were retrospectively analyzed. All patients received oral valganciclovir 900 mg twice daily for 6 weeks followed by 450 mg twice daily for 6 weeks, then were maintained on 0.15% topical ganciclovir ointment. Clinical parameters including intraocular pressure (IOP) and corneal endothelial cell density (ECD) and recurrence were evaluated.

Median age was 51 years; 86.3% were male. During oral therapy, all patients achieved resolution of inflammation and keratic precipitates, with IOP control and reduction in glaucoma medications. No relapse occurred during treatment, but 13 patients (72.2%) recurred after discontinuation, median 4 weeks. Lower baseline and final ECD were seen in recurrence cases. Higher IOP at week 1 was significantly associated with recurrence (p = 0.047). Among relapsed patients, repeated oral therapy frequently led to further relapse, whereas compounded 2% topical ganciclovir achieved sustained remission in most.

A standardized 12-week oral valganciclovir regimen was effective for induction but relapse after discontinuation was common. Early IOP response may predict recurrence, and prolonged maintenance with 2% topical ganciclovir could provide a practical option for high-risk patients.