SEP 2013

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/176967

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Page 63 of 98

September 2013 EW CORNEA Keeping an eye out for CMV endotheliitis One week after the second regraft (third graft) with a clear host cornea. Repeat PCR for CMV on anterior chamber aspirate while patient still on valganciclovir 900 mg twice a day was 1,200 DNA copies/ml. The oral antiviral was reduced to 450 mg twice a day. Source (all): Sadeer Hannush, MD Greater recognition of CMV endotheliitis and increased use of endothelial keratoplasty procedures could increase the amount of occurrences seen and reported by corneal specialists, Dr. Hannush said. Dr. Hannush does not think that CMV-related infections are occurring more. He instead believes that some ophthalmologists are starting to recognize it more often. Still—"I don't think we've managed to get the word out enough about this," he said. "I think we'll see this more. CMV is present in all populations. A lot of people have the antibody," Dr. Tan said. "There must have been cases before where we did not recognize it." Dr. Tan said that previous research finds that positive CMV 61 serology occurs more often in Asian eyes than Caucasian eyes. CMV-related issues are already well known after some other transplants, such as kidney transplants, Dr. Hannush said. There have been reports of CMV endotheliitis not associated with allograft rejection; for example, a 2008 report from Japan focused on eight patients with CMV endotheliitis who had keratic precipitates and multiple coin-shaped lesions along with local corneal stromal edema.4 EW References 1. Hannush SB, Neusidl WB, Eagle RC, Riveroll-Hannush L, Sperling BJ. Cytomegalovirus corneal endotheliitis masquerading as allograft rejection. Abstract 2382/A399. Presented at ARVO 2012, Fort Lauderdale, Fla. 2. Chee SP, Jap A, Wen Ling EC, Ti SE. continued on page 64

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