To study clinical efficacy of valganciclovir in CMVR in HIV positive patients in a tertiary care clinic in developing nation.
In a retrospective case series, we looked at our uveitis clinic database for CMVR cases, who were referred from the ART clinic, and were treated with oral valganciclovir.Systemic, and ocular records of the study patients were collected. Primary outcomes measures were to look for involvement of the other eye, incidence of retinal detachment, systemic involvement, and mortality in the follow-up period. Secondary outcome measures were change in BCVA in the follow-up period
A total of 9 patients (12 eyes) were included in our study. 5 out of 9 patients had co-existent pulmonary tuberculosis and were started on anti-tubercular therapy (ATT). Six out of nine patients (66.67%) presented with unilateral CMVR, whereas three patients (33.33%) had bilateral disease. Zone 1 & 2 involvement was seen in 66.66% of eyes, 11.11 % eyes had only zone 2 involvement, 8.33 % eyes had both zone 2 & 3 involvement, and another 8.33 % had involvement in all the three zones. Majority of our patients (77.77%) had classic variety of CMVR, whereas remaining 22.22% had granular lesions. Two patients developed CMVR in the other eye and only one patient developed retinal detachment during the course of study. No patient developed any systemic manifestations or had mortality during the course of study. The change in BCVA was not statistically significant.
Use of oral valganciclovir showed good outcome, and was found to be better alternative compared to use intravitreal ganciclovir in the literature. Introduction of valganciclovir at an affordable price in developing nations can decrease the disease burden