Zusammenfassung
Cidofovir ist ein Virustatikum aus der Gruppe der Nukleotidanaloga mit Wirksamkeit
gegen Herpesviren. Hauptindikation ist derzeit die Behandlung der CMV-Retinitis. Neuere
Untersuchungen belegen eine zusätzliche Wirksamkeit von Cidofovir bei durch JC-Virus-Reaktivierung
verursachter progressiver multifokaler Leukoenzephalopathie (PML). Schwerwiegendste
okuläre Komplikation bei Verabreichung von Cidofovir stellt die chronische, therapieresistente
Hypotonia bulbi dar, welche durch sekundäre Komplikationen (Makulafalten, Netzhaut-/Aderhautablösung)
zu ausgeprägter, permanenter Visusminderung führen kann. Die Entstehung der Drucksenkung
ist nicht endgültig geklärt. Eine Behandlung derselben ist nur in Einzelfällen beschrieben
worden und in der Effizienz nicht ausreichend gesichert. Als einzig sichere Option
bei Auftreten einer Hypotonie verbleibt der Therapiewechsel von Cidofovir auf alternative
Substanzen. Zur frühzeitigen Erkennung ophthalmologischer Komplikationen bei Cidofovirtherapie
ist eine regelmäßige Kontrolle durch den Augenarzt notwendig.
Abstract
Cidofovir, a nucleotid analogue virostatic drug is effective in the treatment of herpes
virus infections. However, cytomegaly infection is the prime indication due to its
adverse effects. There is growing evidence suggesting cidofovir's effectiveness against
progressive multifocal leukoencephalopathy (PML) caused by a reactivation of JC-virus.
Chronic ocular hypotension which seems to be therapy refractory and anterior uveitis
are considered to be the most serious ocular complications of cidofovir. Secondary
side effects such as macular folds, retinal or choroidal detachment can result in
a permanent loss of vision. Little is known about the pathology of reduced intraocular
pressure and only few reports deal with therapeutical attempts to compensate this
complication. Abandoning cidofovir presently remains the only therapeutic option.
To avoid serious damage it is of utmost importance to monitor all patients undergoing
cidofovir administration for signs of anterior uveitis and ocular hypotension.
Schlüsselwörter
Cidofovir - Hypotonia bulbi - Uveitis anterior - progressive multifokale Leukoenzephalopathie
(PML) - CMV-Retinitis
Key words
Cidofovir - ocular hypotension - anterior uveitis - progressive multifocal leukoencephalopathy
(PML) - cytomegalovirus retinitis
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Dr. U. Hackethal
Klinik und Poliklinik für Augenheilkunde Universitätsklinikum Münster
Domagkstraße 15
48149 Münster
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Fax: + 49/251/835-6003
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