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January 10, 1996

Therapy for Cytomegalovirus Retinitis: Still No Silver Lining

Author Affiliations

From the Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston.

JAMA. 1996;275(2):149-150. doi:10.1001/jama.1996.03530260063034

CYTOMEGALOVIRUS (CMV) retinitis is the leading cause of visual loss in acquired immunodeficiency syndrome (AIDS), occurring in about one third of patients with AIDS. Without treatment, the disease is relentless, eventually leading to complete destruction of the retina. In the past decade, many therapeutic options have been used, but the major breakthrough in the management of this devastating disorder took place with the availability of ganciclovir and foscarnet. However, as both agents are unable to eliminate CMV from the infected retina, lifelong therapy is required. Unfortunately, despite treatment with good compliance, reactivation develops in virtually all patients over time. It is also the general impression that the relapse of the retinitis or development of new lesions takes place in increasingly shorter intervals, indicating that the disease becomes harder to control as immune status of the patient worsens.

See also p 142.

The current management of newly diagnosed CMV retitinis is