title: Sustained-release ganciclovir therapy for treatment of cytomegalovirus retinitis. Use of an intravitreal device.
abstract: A surgically implantable device for sustained intravitreal release of ganciclovir has been developed. The device delivers ganciclovir intraocularly over approximately 4 to 5 months. Eight patients with acquired immunodeficiency syndrome (AIDS) and associated cytomegalovirus (CMV) retinitis were recruited as part of a phase 1 study. Thirteen eyes with active CMV retinitis underwent surgical implantation of the ganciclovir device. All eyes showed resolution of the CMV retinitis; none showed progression. Visual acuity remained unchanged in three eyes, improved in six eyes, and decreased in four eyes. Surgical complications included mild vitreous hemorrhage, astigmatism, and suprachoroidal placement of the device. Retinal detachment occurred in three eyes as the retinitis resolved. This new intraocular drug delivery system offers many advantages compared with intravenous therapy or repeated intravitreal ganciclovir injections for the management of CMV retinitis in patients with AIDS.
authors.affiliation: Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas 75235-9057.
authors.forename: G E
authors.initials: GE
authors.lastname: Sanborn
authors.forename: R
authors.initials: R
authors.lastname: Anand
authors.forename: R E
authors.initials: RE
authors.lastname: Torti
authors.forename: S D
authors.initials: SD
authors.lastname: Nightingale
authors.forename: S X
authors.initials: SX
authors.lastname: Cal
authors.forename: B
authors.initials: B
authors.lastname: Yates
authors.forename: P
authors.initials: P
authors.lastname: Ashton
authors.forename: T
authors.initials: T
authors.lastname: Smith
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D003586:Cytomegalovirus Infections / Q000188:drug therapy*; D003692:Delayed-Action Preparations; D004341:Drug Evaluation; D004343:Drug Implants; D015828:Eye Infections, Viral / Q000188:drug therapy*; D005500:Follow-Up Studies; D015774:Ganciclovir / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012173:Retinitis / Q000188:drug therapy* / Q000382:microbiology; D016896:Treatment Outcome; D014792:Visual Acuity; D014822:Vitreous Body
chemical_list: D003692:Delayed-Action Preparations; D004343:Drug Implants; D015774:Ganciclovir