title: Outcome of cytomegalovirus retinitis in immunocompromised patients without Human Immunodeficiency Virus treated with intravitreal ganciclovir injection.
abstract: OBJECTIVE
  To study the outcomes of treatment with intravitreal ganciclovir injection for cytomegalovirus (CMV) retinitis in patients without Human Immunodeficiency Virus (HIV) infection.
  
  
  METHODS
  In this retrospective cohort study, demographic and clinical characteristics of patients with CMV retinitis without HIV were noted. Patients received intravitreal ganciclovir injection (2 mg/0.1 ml) alone until quiescence. The outcome measures were time taken for the lesions to heal, number of injections, change in best-corrected visual acuity (BCVA), recurrence of retinitis, occurrence of immune recovery uveitis (IRU) or injection-related complications and retinal detachment (RD).
  
  
  RESULTS
  18 eyes of ten patients (six males) with mean age of 33.7 years from June 2004 to March 2013 were included. Thirteen eyes with active lesions (mean BCVA of 0.51 ± 0.41) received 5.54 ± 3.36 intravitreal ganciclovir injections with complete healing within 1.81 ± 1.25 months. The final BCVA was 0.43 ± 0.52. IRU was observed in six eyes (33.33%) and RD developed in one eye. One eye had recurrence 1 month after stopping ganciclovir injections. The rest of the patients had recurrence-free follow-up at 9.46 ± 12.42 months.
  
  
  CONCLUSIONS
  Non-HIV patients with CMV retinitis can be successfully treated with intravitreal ganciclovir injection alone, avoiding the systemic side effects of systemic anti-CMV therapy.
authors.affiliation: Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India, 160012.
authors.forename: Aniruddha
authors.initials: A
authors.lastname: Agarwal
authors.forename: Neha
authors.initials: N
authors.lastname: Kumari
authors.forename: Amita
authors.initials: A
authors.lastname: Trehan
authors.forename: Alka
authors.initials: A
authors.lastname: Khadwal
authors.forename: Mangat R
authors.initials: MR
authors.lastname: Dogra
authors.forename: Vishali
authors.initials: V
authors.lastname: Gupta
authors.forename: Aman
authors.initials: A
authors.lastname: Sharma
authors.forename: Amod
authors.initials: A
authors.lastname: Gupta
authors.forename: Ramandeep
authors.initials: R
authors.lastname: Singh
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D015331:Cohort Studies; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D017726:Cytomegalovirus Retinitis / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D015774:Ganciclovir / Q000009:adverse effects / Q000627:therapeutic use*; D015658:HIV Infections / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D016867:Immunocompromised Host; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000821:virology; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D015774:Ganciclovir