title: Intravitreal sustained-release ganciclovir implants for severe bilateral cytomegalovirus retinitis after stem cell transplantation.
abstract: 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.
authors.affiliation: Department of Ophthalmology, University Hospital, Lund, Sweden. fredrik.ghosh@oft.lu.se
authors.forename: Fredrik
authors.initials: F
authors.lastname: Ghosh
authors.forename: Lars-Jörgen
authors.initials: LJ
authors.lastname: Hansson
authors.forename: Gunnel
authors.initials: G
authors.lastname: Bynke
authors.forename: Albert N
authors.initials: AN
authors.lastname: Békássy
mesh_terms: 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
chemical_list: D000998:Antiviral Agents; D004343:Drug Implants; D015774:Ganciclovir