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Cystoid macular edema in diabetic patients after treatment for CMV retinitis (CMVR) with ganciclovir implants.


Int Conf AIDS. 1998;12:567 (abstract no. 32236). Unique Identifier :

OBJECTIVE: To determine if non-insulin dependent diabetes mellitus (NIDDM) or insulin dependent diabetes mellitus (IDDM) impacts upon the development of cystoid macular edema (CME) after ganciclovir implant (Vitrasert) surgery. DESIGN: Retrospective study. METHODS: The records of 54 patients (76 eyes) who had previously received ganciclovir implants were analyzed (98 procedures performed). Patients were divided into three groups: those having insulin dependent diabetes mellitus (IDDM), those having non-insulin dependent diabetes mellitus (NIDDM), and those not having diabetes (groups 1, 2, and 3). All patients received identical postoperative medications and had the implants placed using the same, standard surgical technique. All patients had frequent, full ophthalmic examinations, including indirect ophthalmoscopy and contact lens examination of the macula. Fluorescein angiography was performed to determine the status of the macula, if deemed necessary on examination. RESULTS: Of 54 patients who received ganciclovir implants between 12/94 and 12/97 (76 eyes), 14 patients (22 eyes) were found to be diabetic. Six (10 eyes) had IDDM, and 8 (12 eyes) had NIDDM. Four patients (66%) or 28% of procedures in group 1 developed CME, while 4 (50%) or 30.8% of procedures in group 2 developed CME. Of the 40 non-diabetic patients, 4 (10%) developed CME, or 5.6% of procedures. There is a statistically significant difference between the groups. CONCLUSION: IDDM may increase the patient's chance of developing CME after implant surgery. Careful postoperative assessment of the macula is warranted, especially in diabetic patients.

MEETING ABSTRACTS Cytomegalovirus Infections/*DRUG THERAPY Diabetes Mellitus, Insulin-Dependent Diabetes Mellitus, Non-Insulin-Dependent Diabetic Retinopathy/*ETIOLOGY Drug Implants Ganciclovir/*ADMINISTRATION & DOSAGE/THERAPEUTIC USE Human Macular Edema, Cystoid/*ETIOLOGY *Postoperative Complications Retinitis/*VIROLOGY Retrospective Studies


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