title: [Intravitreal injection of Ganciclovir in the treatment of acute retinal necrosis].
abstract: OBJECTIVE
  To evaluate the indication and clinical effects of intravitreal injection of Ganciclovir in the treatment of acute retinal necrosis (ARN).
  
  
  METHODS
  Fourteen cases (14 eyes) of ARN which were consistent with the diagnostic criteria of American Uveitis Society were enrolled. Preoperative visual acuity was: light perception, hand movement and counting fingers (CF), each in 1 eye; 0.08 - 0.1 in 4 eyes; 0.2 - 0.4 in 5 eyes 0.5 in 1 eye and 0.8 in 1 eye. Keratic precipitate and aqueous flare were presented in the anterior segment. Peripheral focal and/or patch retinal necrosis, retinal occlusive arteritis and retinal hemorrhage were observed in the fundus. Acyclovir or Ganciclovir was administrated systematically by intravenous injection. The condition of 14 eyes deteriorated underwent intravitreal injection of Ganciclovir but without retinal detachment. After intravitreal injection 2 eyes became worse and underwent vitrectomy for PVR and retinal detachment. The follow-up time varied from 4 to 74 months (mean 25 months).
  
  
  RESULTS
  The inflammation of anterior segment and vitreoretinopathy of 14 cases disappeared after intravitreal injection of Ganciclovir. The visual acuity markedly increased in 12 eyes without surgical intervention. Visual acuity achieved 1.0 - 1.5 in 5 eyes, 0.5 - 0.9 in 5 eyes and 0.3 in 2 eyes after intravitreal injection of Ganciclovir. The retina of the 2 eyes undergone vitrectomy was reattached and their visual acuity improved from CF to 0.4 and LP to CF, respectively.
  
  
  CONCLUSIONS
  In ARN patients whose conditions could not be controlled by systemic antivirus medicine treatment, early intravitreal injection of Ganciclovir can yield satisfactory therapeutic effects and better visual prognoses if applied before the occurrence of PVR or retinal detachment.
authors: Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Eye Research Center of Chinese Academy of Medical Sciences, Beijing 100730, China.
authors: Li-bin
authors: LB
authors: Guo
authors: Ding
authors: D
authors: Sun
authors: Jun-jie
authors: JJ
authors: Ye
authors: Shuang
authors: S
authors: Geng
authors: Hai-yan
authors: HY
authors: Xu
authors: Mei-fen
authors: MF
authors: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D015774:Ganciclovir / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D056965:Injections, Intraocular; D008875:Middle Aged; D015882:Retinal Necrosis Syndrome, Acute / Q000188:drug therapy*; D016896:Treatment Outcome; D014822:Vitreous Body
chemical_list: D000998:Antiviral Agents; D015774:Ganciclovir