The Infectious Uveitis Treatment Algorithm Network (TITAN) Report 2-global current practice patterns for the management of Cytomegalovirus anterior uveitis.

Journal

Eye (London, England)

ISSN: 1476-5454

Titre abrégé: Eye (Lond)

Pays: England

ID NLM: 8703986

Informations de publication

Date de publication:
07 Jul 2023

Historique:

received: 03 09 2022

accepted: 06 06 2023

revised: 03 06 2023

medline: 8 7 2023

pubmed: 8 7 2023

entrez: 7 7 2023

Statut: aheadofprint

Résumé

To present current practice patterns in the diagnosis and management of Cytomegalovirus anterior uveitis (CMV AU) by uveitis experts worldwide. 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. 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). Preferred management practices for CMV AU vary widely. Further research is necessary to refine diagnosis and management and provide higher-level evidence.

Identifiants

DOI: 10.1038/s41433-023-02631-8 PMID: 37419958

pubmed: 37419958

doi: 10.1038/s41433-023-02631-8

pii: 10.1038/s41433-023-02631-8

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Investigateurs

Zheng Xian Thng (ZX)

Ikhwanuliman Putera (I)

Rupesh Agrawal (R)

Ilaria Testi (I)

Mark Westcott (M)

Soon-Phaik Chee (SP)

Andrew D Dick (AD)

John H Kempen (JH)

Manfred Zierhut (M)

Bahram Bodaghi (B)

Jennifer E Thorne (JE)

Talin Barisani-Asenbauer (T)

Marc D de Smet (MD)

Justine R Smith (JR)

Peter McCluskey (P)

Rina La Distia Nora (R)

Douglas A Jabs (DA)

Joke Boer (J)

H Nida Sen (HN)

Debra A Goldstein (DA)

Moncef Khairallah (M)

Janet L Davis (JL)

Quan Dong Nguyen (QD)

Carlos Pavesio (C)

Vishali Gupta (V)

Alan Palestine (A)

Alastair K Denniston (AK)

Alessandro Invernizzi (A)

Amer Radgonde (A)

Amitabh Kumar (A)

Andre Curi (A)

Aniruddha Agarwal (A)

Anita Chan Sook Yee (AC)

Annabelle A Okada (AA)

Ariel Schlaen (A)

Arnd Heiligenhaus (A)

Avinash Gurbaxani (A)

S Bala Murugan (SB)

Cecilia S Lee (CS)

Dipankar Das (D)

Edoardo Baglivo (E)

Ester Carreño (E)

J Fernando Arevalo (JF)

Francesco Pichi (F)

Harvey Uy (H)

Hassan A Al-Dhibi (HA)

James T Rosenbaum (JT)

Justus G Garweg (JG)

Jyotirmay Biswas (J)

Kalpana Babu Murthy (KB)

Laure Caspers (L)

Luca Cimino (L)

Lyndell L Lim (LL)

Maite Sainz de la Maza (MS)

Mamta Agarwal (M)

Manabu Mochizucki (M)

Manisha Agarwal (M)

Marion R Munk (MR)

Massimo Accorinti (M)

Mudit Tyagi (M)

Nicholas P Jones (NP)

Nisha Acharya (N)

Padmamalini Mahendradas (P)

Parthopratim Dutta Majumder (P)

Philip I Murray (PI)

Phoebe Lim (P)

Piergiorgio Neri (P)

Reema Bansal (R)

Russell W Read (RW)

Salil Mehta (S)

Samir S Shoughy Shawki (SS)

Shahana Mazumdar (S)

Shishir Narain (S)

Sofia Androudi (S)

Somasheila Murthy (S)

S R Rathinam (SR)

Stephen Teoh Charn Beng (STC)

Sudharshan Sridharan (S)

Sumita Phatak (S)

Christoph Tappeiner (C)

Timothy Y Y Lai (TYY)

Yew Sen Yuen (YS)

Yun Feng (Y)

Informations de copyright

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