Treatment of cytomegalovirus retinitis with intravitreal ganciclovir. Long-term results

TitleTreatment of cytomegalovirus retinitis with intravitreal ganciclovir. Long-term results
Publication TypeJournal Article
Year of Publication1989
AuthorsCantrill HL, Henry K, Melroe NH, Knobloch WH, Ramsay RC, H., Balfour H. J
Pagination367 - 74
Date PublishedMar
ISSN0161-6420 (Print) 0161-6420 (Linking)
Accession Number2540470
KeywordsAcquired Immunodeficiency Syndrome / *complications, Acyclovir / administration & dosage / *analogs & derivatives, Adult, Cytomegalovirus Infections / complications / *drug therapy, Ganciclovir, Humans, Injections, Long-Term Care, Middle Aged, Opportunistic Infections / complications / *drug therapy, Retinitis / complications / *drug therapy, Vitreous Body / drug effects

Long-term management of cytomegalovirus (CMV) retinitis by intravitreal injection of ganciclovir was evaluated in ten patients with acquired immune deficiency syndrome (AIDS). Patients were unable to tolerate systemic ganciclovir because of severe neutropenia (8 cases), catheter-induced sepsis (1 case), or the need to continue therapy for human immunodeficiency virus (HIV) with zidovudine (ZDV) (1 case). All patients had a favorable response to initial treatment. Cytomegalovirus retinitis progressed in four fellow eyes in which treatment was deferred. Vision improved or remained stable in all but one eye. Patients were followed for a mean of 4 months and received an average of 16.6 intravitreal injections in each eye. Relapse occurred late in the course while on maintenance treatment in five eyes (33%). There was no evidence of toxicity from repeated intravitreal injections. Treatment was very well tolerated. The only severe complication in a total of 249 injections was a single case of Staphylococcus epidermidis endophthalmitis which responded to intravitreal antibiotic treatment. Intravitreal ganciclovir is an effective alternative to systemic ganciclovir in those patients with severe neutropenia and in those patients who desire to remain on systemic ZDV.

URLinternal-pdf://Cantrill - recovery of HIV from ocular tissue-0090323969/Cantrill - recovery of HIV from ocular tissue.pdf;internal-pdf://Cantrill comment - recovery of HIV-0862084609/Cantrill comment - recovery of HIV.pdf
Notify Library Reference ID295

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