INTRAVITREAL SUSTAINED-RELEASE GANCICLOVIR IMPLANTATION TO CONTROL CYTOMEGALOVIRUS RETINITIS IN AIDS

A novel form of therapy, the intravitreal ganciclovir implant (Vitrase rt(R)), was used to treat cytomegalovirus (CMV) retinitis in AIDS, whe n it was not possible to continue systemic therapy or disease progress ion was evident despite conventional intravenous treatment. A review o f the ophthalmic and general health data, operative records and fundus photographs of 9 individuals who had Vitrasert implantation surgery i n Edinburgh. Two patients received bilateral replacement implant proce dures. Visual acuity, concomitant anti-CMV therapy, complications of i mplantation and control of retinitis were documented until final follo w-up. Control of CMV retinitis was achieved in all individuals at one month postoperatively and remained controlled for a mean period of 5.8 months. Postoperative complications were mild and transient in all bu t 2 eyes of 2 patients who developed non-progressive macula oedema. Bl inding complications as a result of surgery were not encountered and r etinal detachment was not observed in this series. Vitrasert implantat ion is an acceptable and well tolerated treatment for CMV retinitis wh en systemic therapy fails to control disease progression.