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February 1992

Sustained-Release Ganciclovir Therapy for Treatment of Cytomegalovirus RetinitisUse of an Intravitreal Device

Author Affiliations

From the Departments of Ophthalmology (Drs Sanborn, Anand, and Torti and Mr Yates) and Medicine (Drs Nightingale and Cal), University of Texas Southwestern Medical Center at Dallas, and the Department of Ophthalmology, University of Kentucky, Lexington (Drs Ashton and Smith). Dr Sanborn is now with Richmond (Va) Retinal Associates. Dr Smith is now with Simmons Eye Associates, Boston, Mass.

Arch Ophthalmol. 1992;110(2):188-195. doi:10.1001/archopht.1992.01080140044023

• A surgically implantable device for sustained intravitreal release of ganciclovir has been developed. The device delivers ganciclovir intraocularly over approximately 4 to 5 months. Eight patients with acquired immunodeficiency syndrome (AIDS) and associated cytomegalovirus (CMV) retinitis were recruited as part of a phase 1 study. Thirteen eyes with active CMV retinitis underwent surgical implantation of the ganciclovir device. All eyes showed resolution of the CMV retinitis; none showed progression. Visual acuity remained unchanged in three eyes, improved in six eyes, and decreased in four eyes. Surgical complications included mild vitreous hemorrhage, astigmatism, and suprachoroidal placement of the device. Retinal detachment occurred in three eyes as the retinitis resolved. This new intraocular drug delivery system offers many advantages compared with intravenous therapy or repeated intravitreal ganciclovir injections for the management of CMV retinitis in patients with AIDS.