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February 1993

Control of Cytomegalovirus Retinitis Using Sustained Release of Intraocular Ganciclovir

Author Affiliations

From the Departments of Ophthalmology (Drs Anand and Fish) and Internal Medicine (Dr Nightingale), University of Texas Southwestern Medical Center at Dallas; Simmons Eye Associates, Boston, Mass (Dr Smith); and the Department of Surgery, University of Kentucky, Lexington (Dr Ashton). Drs Ashton and Smith have a commercial and proprietary interest in the ganciclovir intraocular device; all other authors do not have a commercial or proprietary interest in any of the materials presented in this report.

Arch Ophthalmol. 1993;111(2):223-227. doi:10.1001/archopht.1993.01090020077027

• An experimental intravitreal sustained-release device containing ganciclovir was used to treat 22 patients with acquired immunodeficiency syndrome—associated cytomegalovirus retinitis. Fourteen eyes were excluded (five not involved and nine with macular scarring and/or severe debility). Thirty eyes received the ganciclovir intraocular device implant and were prospectively followed up from 16 to 419 days (median, 125 days). Twenty-seven (90%) of 30 eyes showed stabilization of the retinitis. Nine (33%) of 27 eyes showed reactivation of the retinitis once the device was empty of ganciclovir; seven received a replacement device, with subsequent stabilization of the retinitis. Postoperative complications included vitreous hemorrhage (n=1), endophthalmitis (n=1), and progressive retinitis (n=2). Late retinal detachment was seen in three eyes (11%) at 35 to 140 days. Survival analysis of all 30 eyes revealed the mean time to progression of retinitis to be 19 weeks (133 days). The ganciclovir intraocular device offers a promising alternative for the treatment of cytomegalovirus retinitis associated with acquired immunodeficiency syndrome.