title: Cytomegalovirus retinopathy and the acquired immune deficiency syndrome: results of treatment with ganciclovir.
abstract: Cytomegalovirus (CMV) infection of the retina is the commonest potentially blinding ocular manifestation of AIDS. Recently the acyclic nucleoside dihydroxypropoxymethyl guanine (DHPG, ganciclovir) has become available to treat sight-threatening CMV retinopathy. This paper reports the clinical features and results of ganciclovir therapy in 48 patients seen over a four-year period. Seven patients were excluded from the study due to inadequate follow-up, leaving 41 patients as the study group. All patients responded clinically to this therapy. Patients were treated initially with high-dose ganciclovir (10 mg/kg/day) and then continued on lower dose treatment (5 mg/kg/day) indefinitely. Significant bone marrow toxicity developed in 12 patients (29.3%) requiring temporary cessation of therapy. Patients treated with ganciclovir retained vision and had increased survival times when compared to untreated patients. A poor visual outcome occurred when there was involvement of the macula or optic nerve head at presentation or when there was an interruption of ganciclovir therapy.
authors.affiliation: Laboratory of Ocular Immunology, School of Pathology, University of NSW, Kensington, Australia.
authors.forename: P
authors.initials: P
authors.lastname: McCluskey
authors.forename: D
authors.initials: D
authors.lastname: Wakefield
authors.forename: M
authors.initials: M
authors.lastname: Morgan
authors.forename: R
authors.initials: R
authors.lastname: Binneter
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000914:Antibodies, Viral / Q000276:immunology; D001853:Bone Marrow / Q000187:drug effects; D003587:Cytomegalovirus / Q000187:drug effects / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D004361:Drug Tolerance; D005654:Fundus Oculi; D015774:Ganciclovir / Q000627:therapeutic use*; D015483:HIV Antibodies; D015658:HIV Infections / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012164:Retinal Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D000914:Antibodies, Viral; D015483:HIV Antibodies; D015774:Ganciclovir