The effects of cidofovir 1% with and without cyclosporin a 1% as a topical treatment of acute adenoviral keratoconjunctivitis
| Autor: | Erhard Godehardt, Olaf Cartsburg, Rainer Sundmacher, Daniel Böhringer, Erik De Clercq, Michael Roggendorf, Thomas Reinhard, Jost Hillenkamp, R. S. Ross |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Chemotherapy business.industry medicine.medical_treatment Eye infection Ciclosporin medicine.disease Gastroenterology Surgery Ophthalmology chemistry.chemical_compound Regimen chemistry Cyclosporin a Internal medicine Adenoviral keratoconjunctivitis medicine business Keratoconjunctivitis medicine.drug Cidofovir |
| Zdroj: | Ophthalmology. 109:845-850 |
| ISSN: | 0161-6420 |
| DOI: | 10.1016/s0161-6420(02)00992-2 |
| Popis: | Objective To evaluate the efficacy of cidofovir 1% eyedrops with and without cyclosporin A 1% eyedrops as a treatment of acute adenoviral keratoconjunctivitis (AKC). Design Randomized, controlled trial. Participants Thirty-four patients with acute adenoviral keratoconjunctivitis of recent onset. Methods Patients were divided into 4 treatment groups: 1) cidofovir four times daily, 2) cidofovir 10 times daily, 3) cidofovir four times daily and cyclosporin A four times daily, and 4) sodium chloride four times daily (control). The diagnosis was confirmed by adenoviral polymerase chain reaction from conjunctival swabs. Duration of treatment was 21 days. Main outcome measures Severity of conjunctival injection, conjunctival chemosis, punctate epithelial keratitis during the course of treatment, and presence and severity of corneal subepithelial infiltrates were evaluated by a clinical score. Duration until subjective improvement of symptoms was recorded. Results The frequency of severe corneal opacities was lower with cidofovir ( P = 0.048). Cidofovir was toxic locally to the skin of the eyelids and the conjunctiva in a dose-dependent manner. Symptoms of local toxicity were clinically similar to the signs of the initial viral inflammation. They first appeared 8 to 12 days after beginning of treatment and completely subsided 7 to 28 days after discontinuation of cidofovir. The outcome measures of local inflammation did not differ between the four treatment groups. Cyclosporin A did not alter the course of the infection. Conclusions Cidofovir lowers the frequency of severe corneal opacities, but its clinical use 4 to 10 times daily at a 1% concentration is limited by local toxicity. Further clinical studies to find an efficacious yet tolerable dosage regimen of cidofovir, possibly using an improved pharmaceutical preparation, are required. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|