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Efficacy and tolerance of intravitreal ganciclovir in cytomegalovirus retinitis in acquired immune deficiency syndrome.
Cochereau-Massin I; Lehoang P; Lautier-Frau M; Zazoun L; Marcel P;
February 28, 1992
Ophthalmology. 1991 Sep;98(9):1348-53; discussion 1353-5. Unique

Forty-four patients with acquired immune deficiency syndrome with cytomegalovirus (CMV) retinitis (64 eyes) intolerant of or refusing systemic antiviral therapy received 710 intravitreal injections of ganciclovir at the dosage of 400 micrograms per injection. The patients were followed for a mean period of 9 weeks. Induction therapy consisted of two injections a week until healing. Maintenance therapy consisted of one injection a week until relapse. All but 1 of 53 induction courses led to cicatrization, after a mean of 6.6 injections. In 54 maintenance courses, the 8-week relapse rate was 53%. During intravitreal therapy, involvement of the fellow eye occurred in 11% of the patients and CMV infection developed in a nonocular site in 16% of the patients. Five retinal detachments and two intravitreal hemorrhages occurred. No endophthalmitis or cataract was noted. Intravitreal ganciclovir appears to be a safe and effective alternative in patients intolerant of intravenous anti-CMV drugs.

Acquired Immunodeficiency Syndrome/*COMPLICATIONS Adult Cytomegalovirus Infections/*DRUG THERAPY Drug Tolerance Eye Infections, Viral/*DRUG THERAPY Female Follow-Up Studies Ganciclovir/*THERAPEUTIC USE Human Male Middle Age Prospective Studies Retinal Detachment/ETIOLOGY Retinitis/*DRUG THERAPY/MICROBIOLOGY Vitreous Body Vitreous Hemorrhage/ETIOLOGY JOURNAL ARTICLE