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

Thng, Zheng Xian; Putera, Ikhwanuliman; Testi, Ilaria; Chan, Kevin; Westcott, Mark; Chee, Soon-Phaik; Dick, Andrew D; ... TITAN consensus guidelines group; + view all (2024) The Infectious Uveitis Treatment Algorithm Network (TITAN) Report 2—global current practice patterns for the management of Cytomegalovirus anterior uveitis. Eye , 38 pp. 68-75. 10.1038/s41433-023-02631-8. Green open access

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Dick_TITAN CMV AU EYE revision100223.pdf

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Supp file 1 CMV LIterature Review.pdf - Accepted Version

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Supp file 2 CMV Delphi 1 Survey new.pdf - Accepted Version

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Supp file 3 CMV Delphi 2 Survey new.pdf - Accepted Version

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Supp file 4 new.pdf - Accepted Version

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Abstract

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.

Type: Article
Title: The Infectious Uveitis Treatment Algorithm Network (TITAN) Report 2—global current practice patterns for the management of Cytomegalovirus anterior uveitis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1038/s41433-023-02631-8
Publisher version: https://doi.org/10.1038/s41433-023-02631-8
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Education, Viral infection
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
URI: https://discovery.ucl.ac.uk/id/eprint/10173758
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