Treatment of recurrent cytomegalovirus retinitis with the ganciclovir implant

Daniel B. Roth, William J Feuer, Anita J. Blenke, Janet L Davis

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

PURPOSE: To evaluate preoperative characteristics and outcome of the treatment of recurrent cytomegalovirus (CMV) retinitis with the ganciclovir implant. METHODS: Records of 54 patients with acquired immunodeficiency syndrome and active, previously treated CMV retinitis who received a ganciclovir implant in one (n = 31) or both (n = 23) eyes were reviewed. Entry criteria included prior insertion and removal of an indwelling catheter or failure to respond to tolerated doses of ganciclovir and foscarnet. Preoperative factors that might correlate with outcome were analyzed, including demographic factors, duration of human immunodeficiency virus disease and CMV retinitis, indications for surgery, prior anti-CMV treatment, and extent of retinitis. RESULTS: Forty-six patients completed 1 month of follow-up and were analyzed for outcome. Thirty-one (67.4%) had inactive retinitis at 1 month vs 15 (32.6%) with active retinitis, and they received a mean of 23.5 ± 22.9 weeks of preoperative ganciclovir vs 58.0 ± 52.0 weeks in patients with active retinitis (P = .003). Involvement of more than 25% of retinal area by CMV retinitis was also correlated with activity at 1 month (P < .001). Patients who received implants because of lack of venous access had a median time to progression of 8.0 ± 3.0 months vs 2.0 ± 1.2 months for patients who had inadequate response or intolerance to intravenous medication (P = .073). Patients with 6 months or less vs more than 6 months of preoperative ganciclovir treatment had progression at a median time of 8.0 ± 1.7 months vs 2.0 ± 0.3 months, respectively (P = .016). CONCLUSION: Longer duration of preoperative ganciclovir or larger area of CMV retinitis correlates with lower success of ganciclovir implant therapy for recurrent retinitis.

Original languageEnglish
Pages (from-to)276-282
Number of pages7
JournalAmerican Journal of Ophthalmology
Volume127
Issue number3
DOIs
StatePublished - Mar 1 1999

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Cytomegalovirus Retinitis
Ganciclovir
Retinitis
Therapeutics
Foscarnet
Indwelling Catheters
Virus Diseases
Cytomegalovirus
Acquired Immunodeficiency Syndrome
Demography
HIV

ASJC Scopus subject areas

  • Ophthalmology

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Treatment of recurrent cytomegalovirus retinitis with the ganciclovir implant. / Roth, Daniel B.; Feuer, William J; Blenke, Anita J.; Davis, Janet L.

In: American Journal of Ophthalmology, Vol. 127, No. 3, 01.03.1999, p. 276-282.

Research output: Contribution to journalArticle

Roth, Daniel B. ; Feuer, William J ; Blenke, Anita J. ; Davis, Janet L. / Treatment of recurrent cytomegalovirus retinitis with the ganciclovir implant. In: American Journal of Ophthalmology. 1999 ; Vol. 127, No. 3. pp. 276-282.
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abstract = "PURPOSE: To evaluate preoperative characteristics and outcome of the treatment of recurrent cytomegalovirus (CMV) retinitis with the ganciclovir implant. METHODS: Records of 54 patients with acquired immunodeficiency syndrome and active, previously treated CMV retinitis who received a ganciclovir implant in one (n = 31) or both (n = 23) eyes were reviewed. Entry criteria included prior insertion and removal of an indwelling catheter or failure to respond to tolerated doses of ganciclovir and foscarnet. Preoperative factors that might correlate with outcome were analyzed, including demographic factors, duration of human immunodeficiency virus disease and CMV retinitis, indications for surgery, prior anti-CMV treatment, and extent of retinitis. RESULTS: Forty-six patients completed 1 month of follow-up and were analyzed for outcome. Thirty-one (67.4{\%}) had inactive retinitis at 1 month vs 15 (32.6{\%}) with active retinitis, and they received a mean of 23.5 ± 22.9 weeks of preoperative ganciclovir vs 58.0 ± 52.0 weeks in patients with active retinitis (P = .003). Involvement of more than 25{\%} of retinal area by CMV retinitis was also correlated with activity at 1 month (P < .001). Patients who received implants because of lack of venous access had a median time to progression of 8.0 ± 3.0 months vs 2.0 ± 1.2 months for patients who had inadequate response or intolerance to intravenous medication (P = .073). Patients with 6 months or less vs more than 6 months of preoperative ganciclovir treatment had progression at a median time of 8.0 ± 1.7 months vs 2.0 ± 0.3 months, respectively (P = .016). CONCLUSION: Longer duration of preoperative ganciclovir or larger area of CMV retinitis correlates with lower success of ganciclovir implant therapy for recurrent retinitis.",
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N2 - PURPOSE: To evaluate preoperative characteristics and outcome of the treatment of recurrent cytomegalovirus (CMV) retinitis with the ganciclovir implant. METHODS: Records of 54 patients with acquired immunodeficiency syndrome and active, previously treated CMV retinitis who received a ganciclovir implant in one (n = 31) or both (n = 23) eyes were reviewed. Entry criteria included prior insertion and removal of an indwelling catheter or failure to respond to tolerated doses of ganciclovir and foscarnet. Preoperative factors that might correlate with outcome were analyzed, including demographic factors, duration of human immunodeficiency virus disease and CMV retinitis, indications for surgery, prior anti-CMV treatment, and extent of retinitis. RESULTS: Forty-six patients completed 1 month of follow-up and were analyzed for outcome. Thirty-one (67.4%) had inactive retinitis at 1 month vs 15 (32.6%) with active retinitis, and they received a mean of 23.5 ± 22.9 weeks of preoperative ganciclovir vs 58.0 ± 52.0 weeks in patients with active retinitis (P = .003). Involvement of more than 25% of retinal area by CMV retinitis was also correlated with activity at 1 month (P < .001). Patients who received implants because of lack of venous access had a median time to progression of 8.0 ± 3.0 months vs 2.0 ± 1.2 months for patients who had inadequate response or intolerance to intravenous medication (P = .073). Patients with 6 months or less vs more than 6 months of preoperative ganciclovir treatment had progression at a median time of 8.0 ± 1.7 months vs 2.0 ± 0.3 months, respectively (P = .016). CONCLUSION: Longer duration of preoperative ganciclovir or larger area of CMV retinitis correlates with lower success of ganciclovir implant therapy for recurrent retinitis.

AB - PURPOSE: To evaluate preoperative characteristics and outcome of the treatment of recurrent cytomegalovirus (CMV) retinitis with the ganciclovir implant. METHODS: Records of 54 patients with acquired immunodeficiency syndrome and active, previously treated CMV retinitis who received a ganciclovir implant in one (n = 31) or both (n = 23) eyes were reviewed. Entry criteria included prior insertion and removal of an indwelling catheter or failure to respond to tolerated doses of ganciclovir and foscarnet. Preoperative factors that might correlate with outcome were analyzed, including demographic factors, duration of human immunodeficiency virus disease and CMV retinitis, indications for surgery, prior anti-CMV treatment, and extent of retinitis. RESULTS: Forty-six patients completed 1 month of follow-up and were analyzed for outcome. Thirty-one (67.4%) had inactive retinitis at 1 month vs 15 (32.6%) with active retinitis, and they received a mean of 23.5 ± 22.9 weeks of preoperative ganciclovir vs 58.0 ± 52.0 weeks in patients with active retinitis (P = .003). Involvement of more than 25% of retinal area by CMV retinitis was also correlated with activity at 1 month (P < .001). Patients who received implants because of lack of venous access had a median time to progression of 8.0 ± 3.0 months vs 2.0 ± 1.2 months for patients who had inadequate response or intolerance to intravenous medication (P = .073). Patients with 6 months or less vs more than 6 months of preoperative ganciclovir treatment had progression at a median time of 8.0 ± 1.7 months vs 2.0 ± 0.3 months, respectively (P = .016). CONCLUSION: Longer duration of preoperative ganciclovir or larger area of CMV retinitis correlates with lower success of ganciclovir implant therapy for recurrent retinitis.

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