Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Jan 14;8(1):3.
doi: 10.1186/s40662-020-00226-y.

Management of cytomegalovirus corneal endotheliitis

Angela H Y Wong  1 , Wee Nie Kua  1 , Alvin L Young  2   3 , Kelvin H Wan  4
Affiliations
Review

Management of cytomegalovirus corneal endotheliitis

Angela H Y Wong et al. Eye Vis (Lond). .

Abstract

Background: Cytomegalovirus (CMV) can manifest as corneal endotheliitis in immunocompetent individuals. Early diagnosis is prudent to prevent endothelial cell loss, which could ultimately lead to corneal decompensation. CMV DNA was first detected in an eye with corneal endotheliitis in 2006; since then, clinical evidence from numerous case reports and case series have accumulated.

Main text: In this narrative review, we identified several drugs, including ganciclovir, valganciclovir, and their combination in oral, intravenous, intravitreal, and topical forms in different concentrations, together with the judicious use of topical steroids, have reported variable success. There has yet to be any prospective comparative study evaluating the efficacy and safety of these assorted forms of treatment; clinical evidence is based on case reports and case series. CMV endotheliitis presenting with corneal edema can masquerade as other corneal diseases and thus poses a great challenge especially in post-keratoplasty eyes. Heightened awareness is needed before and after keratoplasty to start prompt prophylaxis and treatment.

Conclusion: There is no consensus on the management of CMV endotheliitis. Further studies are much needed to elucidate the optimal treatment modality, regime, and duration in the treatment and prophylaxis of CMV endotheliitis.

Keywords: CMV; Cornea; Corneal transplant; Cytomegalovirus; Endotheliitis; Keratoplasty.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart showing selection of articles
See this image and copyright information in PMC

References

    1. McGeoch DJ, Gatherer D, Dolan A. On phylogenetic relationships among major lineages of the Gammaherpesvirinae. J Gen Virol. 2005;86(Pt 2):307–316. doi: 10.1099/vir.0.80588-0. - DOI - PubMed
    1. Smith MG. Propagation in tissue cultures of a cytopathogenic virus from human salivary gland virus (SGV) disease. Proc Soc Exp Biol Med. 1956;92(2):424–430. doi: 10.3181/00379727-92-22498. - DOI - PubMed
    1. Hanley PJ, Bollard CM. Controlling cytomegalovirus: helping the immune system take the lead. Viruses. 2014;6(6):2242–2258. doi: 10.3390/v6062242. - DOI - PMC - PubMed
    1. Khodadoust AA, Attarzadeh A. Presumed autoimmune corneal endotheliopathy. Am J Ophthalmol. 1982;93(6):718–722. doi: 10.1016/0002-9394(82)90466-4. - DOI - PubMed
    1. Ohashi Y, Yamamoto S, Nishida K, Okamoto S, Kinoshita S, Hayashi K, et al. Demonstration of herpes simplex virus DNA in idiopathic corneal endotheliopathy. Am J Ophthalmol. 1991;112(4):419–423. doi: 10.1016/S0002-9394(14)76251-8. - DOI - PubMed

LinkOut - more resources