ONCE-WEEKLY INTRAOCULAR INJECTIONS OF GANCICLOVIR FOR MAINTENANCE THERAPY OF CYTOMEGALOVIRUS RETINITIS - CLINICAL AND OCULAR OUTCOME

The clinical course and the outcome of treatment were studied in 40 pa tients with primary cytomegalovirus (CMV) retinitis in 57 eyes. All ha d received one 14-day course of intravenous ganciclovir and all were f ree of other end-organ CMV disease. All afflicted eyes received weekly intravitreal injections of 400 mu g of ganciclovir for maintenance th erapy. Median survival of patients was at least 13 months. Fifteen pat ients had 19 new opportunistic infections during the observation perio d, but none developed new nonocular CMV disease. Active retinitis recu rred in 68.4% of the eyes while receiving maintenance therapy, with a median time to progression of 14.7 weeks. CMV retinitis occurred in 30 .4% of the previously uninvolved eyes (follow-up, 3.1 years). Bacteria l endophthalmitis complicated treatment in 1 eye, and 5 eyes developed a retinal detachment. Thus, the long-term treatment of CMV retinitis with weekly intraocular injections of ganciclovir was associated with survival and ocular outcome similar to those reported with systemic ga nciclovir.