Control of Cytomegalovirus Retinitis Using Sustained Release of Intraocular Ganciclovir

doi:10.1001/archopht.1993.01090020077027

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Vol. 111 No. 2, February 1993

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Control of Cytomegalovirus Retinitis Using Sustained Release of Intraocular Ganciclovir

Rajiv Anand, MD, FRCS; Stephen D. Nightingale, MD; Richard H. Fish, MD; Thomas J. Smith, MD; Paul Ashton, PhD

Arch Ophthalmol. 1993;111(2):223-227.

Abstract

• An experimental intravitreal sustained-release devicecontaining ganciclovir was used to treat 22 patients with acquiredimmunodeficiency syndrome—associated cytomegalovirus retinitis.Fourteen eyes were excluded (five not involved and nine withmacular scarring and/or severe debility). Thirty eyes receivedthe ganciclovir intraocular device implant and were prospectivelyfollowed 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 thedevice was empty of ganciclovir; seven received a replacementdevice, with subsequent stabilization of the retinitis. Postoperativecomplications included vitreous hemorrhage (n=1), endophthalmitis(n=1), and progressive retinitis (n=2). Late retinal detachmentwas seen in three eyes (11%) at 35 to 140 days. Survival analysisof all 30 eyes revealed the mean time to progression of retinitisto be 19 weeks (133 days). The ganciclovir intraocular deviceoffers a promising alternative for the treatment of cytomegalovirusretinitis associated with acquired immunodeficiency syndrome.

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.

Footnotes

Accepted for publication September 24, 1992.

Reprint requests to Department of Ophthalmology, Universityof Texas Southwestern Medical School, 5323 Harry Hines Blvd,Dallas, TX 752359057 (Dr Anand).

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