The Infectious Uveitis Treatment Algorithm Network (TITAN) Report 2-global current practice patterns for the management of Cytomegalovirus anterior uveitis
© 2023. The Author(s), under exclusive licence to The Royal College of Ophthalmologists..
AIMS: To present current practice patterns in the diagnosis and management of Cytomegalovirus anterior uveitis (CMV AU) by uveitis experts worldwide.
METHODS: A two-round modified Delphi survey with masking of the study team was performed. Based on experience and expertise, 100 international uveitis specialists from 21 countries were invited to participate in the survey. Variation in the diagnostic approaches and preferred management of CMV AU was captured using an online survey platform.
RESULTS: Seventy-five experts completed both surveys. Fifty-five of the 75 experts (73.3%) would always perform diagnostic aqueous tap in suspected CMV AU cases. Consensus was achieved for starting topical antiviral treatment (85% of experts). About half of the experts (48%) would only commence systemic antiviral treatment for severe, prolonged, or atypical presentation. The preferred specific route was ganciclovir gel 0.15% for topical treatment (selected by 70% of experts) and oral valganciclovir for systemic treatment (78% of experts). The majority of experts (77%) would commence treatment with topical corticosteroid four times daily for one to two weeks along with antiviral coverage, with subsequent adjustment depending on the clinical response. Prednisolone acetate 1% was the drug of choice (opted by 70% of experts). Long-term maintenance treatment (up to 12 months) can be considered for chronic course of inflammation (88% of experts) and those with at least 2 episodes of CMV AU within a year (75-88% of experts).
CONCLUSIONS: Preferred management practices for CMV AU vary widely. Further research is necessary to refine diagnosis and management and provide higher-level evidence.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
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| Enthalten in: |
Eye (London, England) - 38(2024), 1 vom: 03. Jan., Seite 68-75 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Thng, Zheng Xian [VerfasserIn] |
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| Links: |
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| Themen: |
Antiviral Agents |
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| Anmerkungen: |
Date Completed 05.01.2024 Date Revised 26.01.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1038/s41433-023-02631-8 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM359210155 |
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| 245 | 1 | 4 | |a The Infectious Uveitis Treatment Algorithm Network (TITAN) Report 2-global current practice patterns for the management of Cytomegalovirus anterior uveitis |
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| 500 | |a Date Revised 26.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s), under exclusive licence to The Royal College of Ophthalmologists. | ||
| 520 | |a AIMS: To present current practice patterns in the diagnosis and management of Cytomegalovirus anterior uveitis (CMV AU) by uveitis experts worldwide | ||
| 520 | |a METHODS: A two-round modified Delphi survey with masking of the study team was performed. Based on experience and expertise, 100 international uveitis specialists from 21 countries were invited to participate in the survey. Variation in the diagnostic approaches and preferred management of CMV AU was captured using an online survey platform | ||
| 520 | |a RESULTS: Seventy-five experts completed both surveys. Fifty-five of the 75 experts (73.3%) would always perform diagnostic aqueous tap in suspected CMV AU cases. Consensus was achieved for starting topical antiviral treatment (85% of experts). About half of the experts (48%) would only commence systemic antiviral treatment for severe, prolonged, or atypical presentation. The preferred specific route was ganciclovir gel 0.15% for topical treatment (selected by 70% of experts) and oral valganciclovir for systemic treatment (78% of experts). The majority of experts (77%) would commence treatment with topical corticosteroid four times daily for one to two weeks along with antiviral coverage, with subsequent adjustment depending on the clinical response. Prednisolone acetate 1% was the drug of choice (opted by 70% of experts). Long-term maintenance treatment (up to 12 months) can be considered for chronic course of inflammation (88% of experts) and those with at least 2 episodes of CMV AU within a year (75-88% of experts) | ||
| 520 | |a CONCLUSIONS: Preferred management practices for CMV AU vary widely. Further research is necessary to refine diagnosis and management and provide higher-level evidence | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a de Boer, Joke H |e verfasserin |4 aut | |
| 700 | 1 | |a Sen, H Nida |e verfasserin |4 aut | |
| 700 | 1 | |a Goldstein, Debra A |e verfasserin |4 aut | |
| 700 | 1 | |a Khairallah, Moncef |e verfasserin |4 aut | |
| 700 | 1 | |a Davis, Janet L |e verfasserin |4 aut | |
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| 700 | 1 | |a Nguyen, Quan Dong |e verfasserin |4 aut | |
| 700 | 1 | |a Pavesio, Carlos |e verfasserin |4 aut | |
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| 700 | 1 | |a Thng, Zheng Xian |e investigator |4 oth | |
| 700 | 1 | |a Putera, Ikhwanuliman |e investigator |4 oth | |
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| 700 | 1 | |a Testi, Ilaria |e investigator |4 oth | |
| 700 | 1 | |a Westcott, Mark |e investigator |4 oth | |
| 700 | 1 | |a Chee, Soon-Phaik |e investigator |4 oth | |
| 700 | 1 | |a Dick, Andrew D |e investigator |4 oth | |
| 700 | 1 | |a Kempen, John H |e investigator |4 oth | |
| 700 | 1 | |a Zierhut, Manfred |e investigator |4 oth | |
| 700 | 1 | |a Bodaghi, Bahram |e investigator |4 oth | |
| 700 | 1 | |a Thorne, Jennifer E |e investigator |4 oth | |
| 700 | 1 | |a Barisani-Asenbauer, Talin |e investigator |4 oth | |
| 700 | 1 | |a de Smet, Marc D |e investigator |4 oth | |
| 700 | 1 | |a Smith, Justine R |e investigator |4 oth | |
| 700 | 1 | |a McCluskey, Peter |e investigator |4 oth | |
| 700 | 1 | |a La Distia Nora, Rina |e investigator |4 oth | |
| 700 | 1 | |a Jabs, Douglas A |e investigator |4 oth | |
| 700 | 1 | |a Boer, Joke |e investigator |4 oth | |
| 700 | 1 | |a Sen, H Nida |e investigator |4 oth | |
| 700 | 1 | |a Goldstein, Debra A |e investigator |4 oth | |
| 700 | 1 | |a Khairallah, Moncef |e investigator |4 oth | |
| 700 | 1 | |a Davis, Janet L |e investigator |4 oth | |
| 700 | 1 | |a Nguyen, Quan Dong |e investigator |4 oth | |
| 700 | 1 | |a Pavesio, Carlos |e investigator |4 oth | |
| 700 | 1 | |a Gupta, Vishali |e investigator |4 oth | |
| 700 | 1 | |a Palestine, Alan |e investigator |4 oth | |
| 700 | 1 | |a Denniston, Alastair K |e investigator |4 oth | |
| 700 | 1 | |a Invernizzi, Alessandro |e investigator |4 oth | |
| 700 | 1 | |a Radgonde, Amer |e investigator |4 oth | |
| 700 | 1 | |a Kumar, Amitabh |e investigator |4 oth | |
| 700 | 1 | |a Curi, Andre |e investigator |4 oth | |
| 700 | 1 | |a Agarwal, Aniruddha |e investigator |4 oth | |
| 700 | 1 | |a Sook Yee, Anita Chan |e investigator |4 oth | |
| 700 | 1 | |a Okada, Annabelle A |e investigator |4 oth | |
| 700 | 1 | |a Schlaen, Ariel |e investigator |4 oth | |
| 700 | 1 | |a Heiligenhaus, Arnd |e investigator |4 oth | |
| 700 | 1 | |a Gurbaxani, Avinash |e investigator |4 oth | |
| 700 | 1 | |a Murugan, S Bala |e investigator |4 oth | |
| 700 | 1 | |a Lee, Cecilia S |e investigator |4 oth | |
| 700 | 1 | |a Das, Dipankar |e investigator |4 oth | |
| 700 | 1 | |a Baglivo, Edoardo |e investigator |4 oth | |
| 700 | 1 | |a Carreño, Ester |e investigator |4 oth | |
| 700 | 1 | |a Arevalo, J Fernando |e investigator |4 oth | |
| 700 | 1 | |a Pichi, Francesco |e investigator |4 oth | |
| 700 | 1 | |a Uy, Harvey |e investigator |4 oth | |
| 700 | 1 | |a Al-Dhibi, Hassan A |e investigator |4 oth | |
| 700 | 1 | |a Rosenbaum, James T |e investigator |4 oth | |
| 700 | 1 | |a Garweg, Justus G |e investigator |4 oth | |
| 700 | 1 | |a Biswas, Jyotirmay |e investigator |4 oth | |
| 700 | 1 | |a Murthy, Kalpana Babu |e investigator |4 oth | |
| 700 | 1 | |a Caspers, Laure |e investigator |4 oth | |
| 700 | 1 | |a Cimino, Luca |e investigator |4 oth | |
| 700 | 1 | |a Lim, Lyndell L |e investigator |4 oth | |
| 700 | 1 | |a de la Maza, Maite Sainz |e investigator |4 oth | |
| 700 | 1 | |a Agarwal, Mamta |e investigator |4 oth | |
| 700 | 1 | |a Mochizucki, Manabu |e investigator |4 oth | |
| 700 | 1 | |a Agarwal, Manisha |e investigator |4 oth | |
| 700 | 1 | |a Munk, Marion R |e investigator |4 oth | |
| 700 | 1 | |a Accorinti, Massimo |e investigator |4 oth | |
| 700 | 1 | |a Tyagi, Mudit |e investigator |4 oth | |
| 700 | 1 | |a Jones, Nicholas P |e investigator |4 oth | |
| 700 | 1 | |a Acharya, Nisha |e investigator |4 oth | |
| 700 | 1 | |a Mahendradas, Padmamalini |e investigator |4 oth | |
| 700 | 1 | |a Dutta Majumder, Parthopratim |e investigator |4 oth | |
| 700 | 1 | |a Murray, Philip I |e investigator |4 oth | |
| 700 | 1 | |a Lim, Phoebe |e investigator |4 oth | |
| 700 | 1 | |a Neri, Piergiorgio |e investigator |4 oth | |
| 700 | 1 | |a Bansal, Reema |e investigator |4 oth | |
| 700 | 1 | |a Read, Russell W |e investigator |4 oth | |
| 700 | 1 | |a Mehta, Salil |e investigator |4 oth | |
| 700 | 1 | |a Shoughy Shawki, Samir S |e investigator |4 oth | |
| 700 | 1 | |a Mazumdar, Shahana |e investigator |4 oth | |
| 700 | 1 | |a Narain, Shishir |e investigator |4 oth | |
| 700 | 1 | |a Androudi, Sofia |e investigator |4 oth | |
| 700 | 1 | |a Murthy, Somasheila |e investigator |4 oth | |
| 700 | 1 | |a Rathinam, S R |e investigator |4 oth | |
| 700 | 1 | |a Beng, Stephen Teoh Charn |e investigator |4 oth | |
| 700 | 1 | |a Sridharan, Sudharshan |e investigator |4 oth | |
| 700 | 1 | |a Phatak, Sumita |e investigator |4 oth | |
| 700 | 1 | |a Tappeiner, Christoph |e investigator |4 oth | |
| 700 | 1 | |a Lai, Timothy Y Y |e investigator |4 oth | |
| 700 | 1 | |a Yuen, Yew Sen |e investigator |4 oth | |
| 700 | 1 | |a Feng, Yun |e investigator |4 oth | |
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