Control of cytomegalovirus retinitis using sustained release of intraocular ganciclovir.
An experimental intravitreal sustained-release device containing ganciclovir was used to treat 22 patients with acquired immunodeficiency syndrome-associated cytomegalovirus retinitis. Fourteen eyes were excluded (five not involved and nine with macular scarring and/or severe debility). Thirty eyes received the ganciclovir intraocular device implant and were prospectively followed up from 16 to 419 days (median, 125 days). Twenty-seven (90%) of 30 eyes showed stabilization of the retinitis. Nine (33%) of 27 eyes showed reactivation of the retinitis once the device was empty of ganciclovir; seven received a replacement device, with subsequent stabilization of the retinitis. Postoperative complications included vitreous hemorrhage (n = 1), endophthalmitis (n = 1), and progressive retinitis (n = 2). Late retinal detachment was seen in three eyes (11%) at 35 to 140 days. Survival analysis of all 30 eyes revealed the mean time to progression of retinitis to be 19 weeks (133 days). The ganciclovir intraocular device offers a promising alternative for the treatment of cytomegalovirus retinitis associated with acquired immunodeficiency syndrome.
Anand
R
R
Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas.
Nightingale
S D
SD
Fish
R H
RH
Smith
T J
TJ
Ashton
P
P
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D000328:Adult; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D003692:Delayed-Action Preparations; D004343:Drug Implants; D005500:Follow-Up Studies; D015774:Ganciclovir / Q000008:administration & dosage* / Q000627:therapeutic use; D006785:Hospitals, University; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012008:Recurrence; D012173:Retinitis / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D012720:Severity of Illness Index; D016019:Survival Analysis; D013781:Texas / Q000453:epidemiology; D014792:Visual Acuity
D003692:Delayed-Action Preparations; D004343:Drug Implants; D015774:Ganciclovir