The ganciclovir implant (Vitrasert, Chiron, Emoryville, Calif) offers patients with cytomegalovirus (CMV) retinitis potential freedom from daily intravenous infusions or weekly intravitreal injections of ganciclovir, foscarnet, or both.1 Potential problems with this method of treatment include lack of systemic CMV coverage, no treatment of the contralateral eye, development of ganciclovir resistance, and direct complications of the implant surgery. We describe the reactivation of CMV retinitis that developed in a patient in the early postoperative period following ganciclovir implant placement. This potentially visionthreatening complication should be considered in any patient receiving the ganciclovir implant.
Report of a Case.
A 37-year-old man with human immunodeficiency virus was diagnosed with active granular CMV retinitis in the left eye. His visual acuity on presentation was 20/25 OD and 20/40 OS. The patient refused systemic treatment and a therapeutic regimen of weekly intravitreal injections of ganciclovir (200-2000 μg) was started. He responded dramatically to
Friedlander SM, Goldstein DA. Early Reactivation of Cytomegalovirus Retinitis Following Placement of a Ganciclovir Implant. Arch Ophthalmol. 1997;115(6):802-803. doi:10.1001/archopht.1997.01100150804022