Progression rates of cytomegalovirus retinopathy in ganciclovir-treated and untreated patients
G. N. Holland and J. D. Shuler
UCLA Ocular Inflammatory Disease Center, Jules Stein Eye Institute 90024-7003.
Cytomegalovirus retinopathy lesions in patients with the acquired
immunodeficiency syndrome may continue to enlarge despite ganciclovir
sodium treatment. In an historical cohort study, we used serial, masked
retinal photographs to calculate progression rates for 14
ganciclovir-treated patients known to have disease progression and for 17
untreated patients. The median period of evaluation was 23.5 days for
ganciclovir-treated patients and 28 days for untreated patients (P = .89).
In both groups, the rate at which borders of preexisting lesions advanced
into uninfected retina varied in different directions. Anterior progression
rates were usually faster than posterior progression rates. The median
progression rate with which disease approached the fovea in
ganciclovir-treated patients was 11.5 microns/d (range, 0 to 25.0
microns/d) and the median progression rate for untreated patients was 24.0
microns/d (range, 0 to 164.0 microns/d) (P = .01). These results suggest
that ganciclovir provides a therapeutic benefit for patients with
progressive disease by slowing the rate with which infection spreads. The
size and appearance of lesions may also be related to their response to
treatment and to progression rates of untreated disease.
