High-dose (2000-μg) intravitreous ganciclovir in the treatment of cytomegalovirus retinitis11The authors have no financial interest in the drugs or methods described in this article.

Young, Stephanie; Morlet, Nigel; Besen, Gilberto; Wiley, Clayton A.; Jones, Philip; Gold, Julian; Li, Yueming; Freeman, William R.; Coroneo, Minas T.

doi:10.1016/s0161-6420(98)98020-4

Cited by 53 publications

(9 citation statements)

References 31 publications

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“…On the other hand intravitreal ganciclovir is more efficient in treating CMV retinitis than intravenous (i.v.) administration of the drug (Young et al. 1998), which is well illustrated in our patient who received both foscarnet and ganciclovir i.v., but still progressed in his retinitis.…”

Section: Discussionsupporting

confidence: 55%

“…Additionally, local ganciclovir therapy minimizes the hazardous side‐effects of i.v. ganciclovir (bone marrow suppression) and foscarnet (nephrotoxicity), and has shown very little, if any, adverse effects on the ocular tissues (Charles & Steiner 1996; Young et al. 1998).…”

Section: Discussionmentioning

confidence: 99%

“…Treatment was intensified to include both ganciclovir and foscarnet intravenously, but the retinitis progressed with more infiltrates, hemorrhages and increasing exudative lesions in both maculae. To save the retinae, intravitreal injections of ganciclovir according to the protocol developed by Young et al. (1998) was started in both eyes, five months after the stem cell transplant.…”

Section: Case Reportmentioning

confidence: 99%

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Intravitreal sustained‐release ganciclovir implants for severe bilateral cytomegalovirus retinitis after stem cell transplantation

Ghosh¹,

Hansson²,

Bynke³

et al. 2002

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To describe the treatment of cytomegalovirus (CMV) retinitis with intravitreal sustain-release ganciclovir devices in a 16-year-old patient in third remission of acute lymphoblastic leukemia after stem cell transplantation. Methods: The patient received a stem cell transplant from an unrelated bone marrow donor after which he contracted a serious CMV infection manifested in the lungs and retinae. His immune system at this time was almost completely depleted. Implantation of a sustained-release ganciclovir device was performed in both eyes when retinitis progressed in spite of aggressive antiviral intravenous treatment.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

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Intravitreal sustained‐release ganciclovir implants for severe bilateral cytomegalovirus retinitis after stem cell transplantation

Ghosh¹,

Hansson²,

Bynke³

et al. 2002

Acta Ophthalmologica Scandinavica

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“…Young et al reported a 100 % success percentage with three biweekly 2 mg/0.1 mL of IVTG followed by weekly IVTG maintenance. However, it resulted in a 7 % relapse with median relapse time of 42 weeks [ 19 ]. In our cohort, there was no relapse after stopping the medication, but the follow-up time was limited to 24 weeks, which was probably insufficient to evaluate the actual relapse time of IVTG.…”

Section: Discussionmentioning

confidence: 99%

Treatment outcomes of reduced-dose intravitreal ganciclovir for cytomegalovirus retinitis

et al. 2016

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BackgroundCytomegalovirus retinitis (CMVR) is one of the most common opportunistic infection in immunocompromised individuals. Intravitreal ganciclovir injection has been used successfully but no standard regimen was established. Risks of drug toxicity, endophthalmitis, and injection-related complications increased with number and frequency of injection. The aim of this study is to evaluate the outcomes of reduced-dose intravitreal ganciclovir (2 mg/0.04 mL) for the treatment of CMVR.MethodsA prospective observational cohort study involving 67 eyes of 49 patients with CMVR was performed. Induction therapy involved intravenous ganciclovir (10 mg/kg/day) for 2 weeks unless contraindicated or patients refused. Patients were then treated with reduced-dose intravitreal ganciclovir every week for 4 weeks, and then every other week until the lesion healed. The patients’ demographic data were recorded, and vision parameters were examined every visit.ResultsTwenty eyes (29.9 %) presented with initial visual acuities less than 6/60. The majority of patients were diagnosed with CMVR in zones 1 or 2 (63 eyes, 94 %), and, at least, one quadrant of the retina was involved (56 eyes, 83.6 %). Forty-one eyes (61.2 %) completely resolved after treatment within the 6-month follow-up. There was no significant difference in healing time, whether or not patients received induction treatment with intravenous ganciclovir (111.00 ± 12.96 vs 105.00 ± 28.32 days, p = 0.8). Five eyes (12.2 %) of patients with healed CMVR had visual acuities less than 6/60.ConclusionsReduced-dose intravitreal ganciclovir is a safe and effective treatment option. It provides comparable results to other weekly regimens. Induction with intravenous ganciclovir is not crucial in a resolution of retinitis, although it may be necessary to reduce systemic cytomegalovirus loads and mortality rates.Trial registrationThe trial was registered with Thai Clinical Trials Registry (TCTR) on 16 March 2016 – TCTR20160316001.

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“…66–73 Repetitive intravitreous injections of ganciclovir, foscarnet, and cidofovir reportedly are effective for secondary prophylaxis of CMV retinitis, 74,75 although intraocular therapy alone does not protect the contralateral eye or other organ systems and therefore typically is combined with systemic treatment. 66 Frequent intravitreous injections also are impractical for use in most children (AIII) .…”

Section: Cytomegalovirus (Last Updated November 6 2013; Last Reviewementioning

confidence: 99%

Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children

Siberry

Abzug

Nachman

et al. 2013

Pediatric Infectious Disease Journal

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High-dose (2000-μg) intravitreous ganciclovir in the treatment of cytomegalovirus retinitis11The authors have no financial interest in the drugs or methods described in this article.

Cited by 53 publications

References 31 publications

Intravitreal sustained‐release ganciclovir implants for severe bilateral cytomegalovirus retinitis after stem cell transplantation

Intravitreal sustained‐release ganciclovir implants for severe bilateral cytomegalovirus retinitis after stem cell transplantation

Treatment outcomes of reduced-dose intravitreal ganciclovir for cytomegalovirus retinitis

Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children

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