Use of intravitreal ganciclovir (dihydroxy propoxymethyl guanine) for cytomegalovirus retinitis in a patient with AIDS.
A patient with acquired immune deficiency syndrome with bilateral cytomegalovirus retinitis was treated with intravitreal 200-micrograms/0.1-ml doses of ganciclovir (9-[2-hydroxy-1-(hydroxymethyl) ethoxymethyl]guanine). The ganciclovir serum and intravitreal concentrations were measured with an enzyme-linked immunosorbent assay and pharmacokinetic factors were determined. There was no evidence of systemic absorption of ganciclovir from the eye. The elimination half-life of ganciclovir from the vitreous was estimated to be 13.3 hours. The intravitreal concentration remained above the ID50 of cytomegalovirus for approximately 62 hours after a single injection. Clinically, the patient retained useful vision in his right eye for three months. A total of 28 intravitreal injections were given on an outpatient basis under topical anesthesia and were well tolerated. There was no evidence of retinal toxicity from the drug.
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000212:Acyclovir / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000378:metabolism; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000378:metabolism; D003586:Cytomegalovirus Infections / Q000188:drug therapy*; D015774:Ganciclovir; D006801:Humans; D007267:Injections; D008297:Male; D012173:Retinitis / Q000188:drug therapy* / Q000209:etiology; D014792:Visual Acuity / Q000187:drug effects; D014822:Vitreous Body / Q000378:metabolism
D000998:Antiviral Agents; D015774:Ganciclovir; D000212:Acyclovir