Purpose: To report a case of anterior uveitis and ocular hypotony during HPMPC treatment of a cytomegalovirus infection without ophthalmic involvement.
Methods: A 61-year-old bisexual white man with AIDS presented with moderate anterior uveitis and ocular hypotony after 8 weeks of intravenous HPMPC and oral probenecid co-treatment of a presumed recurrence of cytomegalovirus encephalitis.
Results: There was no evidence of an ocular cytomegalovirus infection. Cidofovir-related uveitis was diagnosed, and the HPMPC-probenecid co-treatment was switched to ganciclovir monotherapy. The ocular inflammation was successfully managed with topical steroids and mydriatics.
Conclusions: This description of ophthalmic side effects from systemic HPMPC in the absence of ocular cytomegalovirus infection supports the hypothesis that anterior uveitis and ocular hypotony result from a direct interaction between the drug and the ciliary body.