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

Graefes Arch Clin Exp Ophthalmol. 2014 Sep;252(9):1393-401. doi: 10.1007/s00417-014-2587-5. Epub 2014 Feb 21.

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.

MeSH terms

  • Adolescent
  • Adult
  • Antiviral Agents / adverse effects
  • Antiviral Agents / therapeutic use*
  • Child
  • Cohort Studies
  • Cytomegalovirus / genetics
  • Cytomegalovirus / isolation & purification
  • Cytomegalovirus Retinitis / diagnosis
  • Cytomegalovirus Retinitis / drug therapy*
  • Cytomegalovirus Retinitis / physiopathology
  • Female
  • Ganciclovir / adverse effects
  • Ganciclovir / therapeutic use*
  • HIV Infections / drug therapy
  • HIV Infections / 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

Substances

  • Antiviral Agents
  • Ganciclovir