Use of the ganciclovir implant in the treatment of recurrent cytomegalovirus retinitis

J. L. Marx, M. A. Kapusta, S. S. Patel, L. D. LaBree, F. Walonker, N. A. Rao and L. P. Chong
Doheny Eye Institute, Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles, USA.

OBJECTIVE: To evaluate the efficacy of the ganciclovir implant in the treatment of recurrent cytomegalovirus (CMV) retinitis. METHODS: Patients with acquired immunodeficiency syndrome and recurrent CMV retinitis were evaluated for entry into the study. A ganciclovir implant was inserted in 91 eyes of 70 patients between October 1992 and October 1995. The efficacy of the implant and visual results were retrospectively reviewed. RESULTS: Fifty-three (76%) of 70 eyes had inactive CMV retinitis 1 month postoperatively (positive initial response). Twenty-one eyes of 19 patients had less than 1 month of follow-up. Nineteen (36%) of 53 eyes developed recurrent CMV retinitis. The median time to recurrence for those patients with a positive initial response was 7 months. Forty-eight (84%) of 57 patients with follow-up longer than 1 month after implant insertion in the first eye received systemic anti-CMV medication during the study. The cumulative risk for developing a retinal detachment was 23% at 6 months following implant insertion. Other complications included vitreous hemorrhage, hyphema, and suprachoroidal implantation of the device. CONCLUSION: The ganciclovir implant is effective as an adjunct to continued systemic therapy in those patients with recurrent CMV retinitis.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Ganciclovir Implant With Cystlike Abnormality
Yenerel et al.
Arch Ophthalmol 2005;123:282-283.
FULL TEXT  

Ultrasound biomicroscopic study of sclelotomy sites after implantation of sustained release drug devices
Kunimatsu et al.
Br. J. Ophthalmol. 2002;86:869-871.
ABSTRACT | FULL TEXT  

Scleral Plug of Biodegradable Polymers Containing Ganciclovir for Experimental Cytomegalovirus Retinitis
Sakurai et al.
IOVS 2001;42:2043-2048.
ABSTRACT | FULL TEXT  

Intravitreal Toxicology and Duration of Efficacy of a Novel Antiviral Lipid Prodrug of Ganciclovir in Liposome Formulation
Cheng et al.
IOVS 2000;41:1523-1532.
ABSTRACT | FULL TEXT  

A Single-Suture Technique for Placement of the Ganciclovir Implant
Jones and Weinberg
Arch Ophthalmol 2000;118:584-585.
ABSTRACT | FULL TEXT  

Guidelines for the Treatment of Cytomegalovirus Diseases in Patients With AIDS in the Era of Potent Antiretroviral Therapy: Recommendations of an International Panel
Whitley et al.
Arch Intern Med 1998;158:957-969.
ABSTRACT | FULL TEXT  

Sustained release intravitreal ganciclovir implant as salvage treatment in AIDS related cytomegalovirus retinitis
KAMAL et al.
Br. J. Ophthalmol. 1998;82:332b-332.
FULL TEXT  

Treatment of Cytomegalovirus Retinitis in Patients with the Acquired Immunodeficiency Syndrome
Jacobson
NEJM 1997;337:105-114.
FULL TEXT