title: Treatment of cytomegalovirus retinopathy with ganciclovir.
abstract: Ganciclovir is an experimental antiviral drug with activity against human cytomegalovirus (CMV). Forty patients with acquired immune deficiency syndrome (AIDS) and CMV retinopathy were treated with ganciclovir on a compassionate protocol basis. Initial treatment doses ranged from 5.0 to 14.0 mg/kg/day for 9 to 26 days. Signs of drug response were a halt to enlargement of lesions, decreased opacification of retinal tissue, and resolution of hemorrhage and vasculitis. Complete response was seen in 88% of patients and incomplete response was seen in 9%. Vision improved or remained stable in 88% of patients. Initial treatment did not eradicate live virus from the eye. To prevent reactivation of disease, 26 patients received low-dose maintenance therapy ranging from 1.5 to 7.5 mg/kg/day, once or twice daily, 3 to 7 days per week. Reactivation of disease developed for unknown reasons in 50% of patients on continuous, uninterrupted maintenance therapy for longer than 3 weeks. Reversible neutropenia, requiring cessation of treatment, developed in 30% of patients on initial treatment and in 38% of patients on maintenance therapy. Rhegmatogenous retinal detachment was a late complication in seven patients. By reducing or delaying visual loss, ganciclovir appears to be useful in the management of CMV retinopathy in patients with AIDS.
authors.affiliation: UCLA Uveitis Center, Jules Stein Eye Institute, Los Angeles, CA 90024.
authors.forename: G N
authors.initials: GN
authors.lastname: Holland
authors.forename: Y
authors.initials: Y
authors.lastname: Sidikaro
authors.forename: A E
authors.initials: AE
authors.lastname: Kreiger
authors.forename: D
authors.initials: D
authors.lastname: Hardy
authors.forename: M J
authors.initials: MJ
authors.lastname: Sakamoto
authors.forename: L M
authors.initials: LM
authors.lastname: Frenkel
authors.forename: D J
authors.initials: DJ
authors.lastname: Winston
authors.forename: M S
authors.initials: MS
authors.lastname: Gottlieb
authors.forename: Y J
authors.initials: YJ
authors.lastname: Bryson
authors.forename: R E
authors.initials: RE
authors.lastname: Champlin
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000212:Acyclovir / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D003586:Cytomegalovirus Infections / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D015774:Ganciclovir; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D012160:Retina / Q000473:pathology; D012164:Retinal Diseases / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D014785:Vision, Ocular
chemical_list: D015774:Ganciclovir; D000212:Acyclovir