Outcome of cytomegalovirus retinitis in immunocompromised patients without Human Immunodeficiency Virus treated with intravitreal ganciclovir injection.

Abstract

PURPOSE:

To study the outcomes of treatment with intravitreal ganciclovir injection for cytomegalovirus (CMV) retinitis in patients without Human Immunodeficiency Virus (HIV) infection.

METHODS:

In this retrospective cohort study, demographic and clinical characteristics of patients with CMV retinitis without HIV were noted. Patients received intravitreal ganciclovir injection (2 mg/0.1 ml) alone until quiescence. The outcome measures were time taken for the lesions to heal, number of injections, change in best-corrected visual acuity (BCVA), recurrence of retinitis, occurrence of immune recovery uveitis (IRU) or injection-related complications and retinal detachment (RD).

RESULTS:

18 eyes of ten patients (six males) with mean age of 33.7 years from June 2004 to March 2013 were included. Thirteen eyes with active lesions (mean BCVA of 0.51 ± 0.41) received 5.54 ± 3.36 intravitreal ganciclovir injections with complete healing within 1.81 ± 1.25 months. The final BCVA was 0.43 ± 0.52. IRU was observed in six eyes (33.33%) and RD developed in one eye. One eye had recurrence 1 month after stopping ganciclovir injections. The rest of the patients had recurrence-free follow-up at 9.46 ± 12.42 months.

CONCLUSIONS:

Non-HIV patients with CMV retinitis can be successfully treated with intravitreal ganciclovir injection alone, avoiding the systemic side effects of systemic anti-CMV therapy.

• Authors: Aniruddha Agarwal, Neha Kumari, Amita Trehan, Alka Khadwal, Mangat R Dogra, Vishali Gupta, Aman Sharma, Amod Gupta, Ramandeep Singh
• Journal: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (Graefes Arch Clin Exp Ophthalmol) Vol. 252 Issue 9 Pg. 1393-401 (Sep 2014) ISSN: 1435-702X [Electronic] Germany
• PMID: 24557658 (Publication Type: Journal Article)

Chemical References

• Antiviral Agents
• Ganciclovir

Topics

• Adolescent
• Adult
• Antiviral Agents (adverse effects, therapeutic use)
• Child
• Cohort Studies
• Cytomegalovirus (genetics, isolation & purification)
• Cytomegalovirus Retinitis (diagnosis, drug therapy, physiopathology)
• Female
• Ganciclovir (adverse effects, therapeutic use)
• HIV Infections (drug therapy, physiopathology)
• Humans
• Immunocompromised Host
• Intravitreal Injections
• Male
• Middle Aged
• Polymerase Chain Reaction
• Recurrence
• Retrospective Studies
• Treatment Outcome
• Visual Acuity (physiology)
• Vitreous Body (virology)
• Young Adult