Intravitreal sustained-release ganciclovir implants for severe bilateral cytomegalovirus retinitis after stem cell transplantation.
OBJECTIVE
To describe the treatment of cytomegalovirus (CMV) retinitis with intravitreal sustain-release ganciclovir devices in a 16-year-old patient in third remission of acute lymphoblastic leukemia after stem cell transplantation.


METHODS
The patient received a stem cell transplant from an unrelated bone marrow donor after which he contracted a serious CMV infection manifested in the lungs and retinae. His immune system at this time was almost completely depleted. Implantation of a sustained-release ganciclovir device was performed in both eyes when retinitis progressed in spite of aggressive antiviral intravenous treatment.


RESULTS
No per- or postoperative complications were noted. Infiltrates, hemorrhages and macular edema present preoperatively dissolved over a period of six months. The final visual acuity was 1.0 in both eyes. The patients immune system and lung function slowly recovered during the same time period.


CONCLUSIONS
The intravitreal ganciclovir implant provides safe and effective therapy against CMV retinitis, and should be considered in patients acquiring the infection after stem cell transplantation.
Ghosh
Fredrik
F
Department of Ophthalmology, University Hospital, Lund, Sweden. fredrik.ghosh@oft.lu.se
Hansson
Lars-Jörgen
LJ
Bynke
Gunnel
G
Békássy
Albert N
AN
D000293:Adolescent; D000998:Antiviral Agents / Q000008:administration & dosage*; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy* / Q000209:etiology; D004343:Drug Implants; D015774:Ganciclovir / Q000008:administration & dosage*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007107:Immune System / Q000502:physiology; D007165:Immunosuppression Therapy; D008168:Lung / Q000502:physiology; D008297:Male; D011024:Pneumonia, Viral / Q000188:drug therapy / Q000209:etiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy; D014822:Vitreous Body
D000998:Antiviral Agents; D004343:Drug Implants; D015774:Ganciclovir