Valganciclovir therapy for immune recovery uveitis complicated by macular edema

Purpose To determine whether treatment with valganciclovir will improve visual acuity in eyes with immune recovery uveitis complicated by macular edema. Design Prospective open label controlled Phase II drug study. Methods Five patients with chronic macular edema as a result of immune recovery uveitis were studied. Baseline fluorescein angiograms, best-corrected ETDRS visions, and cytomegalovirus (CMV) lymphoproliferative T-cell function assays were obtained and repeated after three months of valganciclovir therapy (900 mg daily) and again three months after withdrawal of therapy. Results Vision improved by a mean of 11 letters in the treatment phase (P = .05). Graded angiograms showed three patients had treatment reduction of macular edema. One patient had rebound increase in macular edema after the withdrawal phase. The CMV lymphoproliferative response was not affected by the valganciclovir. Conclusion Results suggest valganciclovir treatment may benefit visual acuity in patients with macular edema from immune recovery uveitis.