The treatment of clinically resistant cytomegalovirus retinitis in AIDS patients requires a combination of foscarnet and ganciclovir, but the poor clinical condition of some patients may weigh against this intravenous regimen. We treated three patients with high-dose intravitreal foscarnet (2400 μg/0.1 ml; 25 injections; mean follow-up 14.6 weeks)combined with intravenous ganciclovir (5 mg/kg twice daily), and obtained complete control of the retinitis in a mean time of 3.4 weeks with no ocular or systemic side effects and no other eye/organ cytomegalovirus dissemination. This combined therapy seems useful for clinically resistant cytomegalovirus retinitis in AIDS patients.
HollandG.N., SidikaroY., KreigerA.E.Treatment of cytomegalovirus retinopathy with ganciclovir. Ophthalmology1987; 94: 815–23.
2.
Cocherau-MassinI., LeHoangP., Lautier-FrauM.Efficacy and tolerance of intravitreal ganciclovir in cytomegalovirus retinitis in acquired immune deficiency syndrome. Ophthalmology1991; 98: 1348–55.
3.
Studies of Ocular Complications of AIDS Research Group, in collaboration with the AIDS Clinical Trials Group. Mortality in patients with the acquired immunodeficiency syndrome treated with either foscarnet or ganciclovir for cytomegalovirus retinitis. N Eng J Med1992; 326: 213–20.
4.
Diaz - LlopisM., ChipontE., SanchezS., EspanaE., NaveaA., MenezoJ.L.Intravitreal foscarnet for cytomegalovirus retinitis in a patient with acquired immunodeficiency syndrome. Am J Ophthalmol1992; 114: 742–7.
5.
Diaz-LlopisM., EspanaE., MunozG.High dose intravitreal foscarnet in the treatment of cytomegalovirus retinitis in AIDS. Br J Ophthalmol1994; 78: 120–4.
6.
LiebermanR.M., OrellanaJ.Efficacy of intravitreal foscarnet in patients with AIDS. N Eng J Med1994; 330: 868–9.
7.
Pivetti-PezziP.Opportunistic retinal infections in AIDS. In: DernouchampsJ.P., VerougstraeteC., Caspers-VeluL., TassignonM.J., eds. Recent advances in uveitis.Amsterdam: Kugler Publications, 1993, 293-9.
8.
KuppermannB.D., Flores-AguilarM., QuicenoJ.I., RickmanL.S., FreemanW.R.Combination ganciclovir and foscarnet in the treatment of clinically resistant cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome. Arch Ophthalmol1993; 111: 1359–66.
9.
Flores-AguilarM., KuppermannB.D., QuicenoJ.I.Pathophysiology and treatment of clinically resistant cytomegalovirus retinitis. Ophthalmology1993; 100: 1022–31.
10.
AnandR., NightingaleSD, FishR.H., SmithT.J., AshtonP.Control of cytomegalovirus retinitis using sustained release of intraocular ganciclovir. Arch Ophthalmol1993; 111: 223–7.
11.
MartinD.F., ParksD.J., MellowS.D.Treatment of cytomegalovirus retinitis with an intraocular sustained-release ganciclovir implant. A randomized controlled clinical trial. Arch Ophthalmol1994; 112: 1531–9.
HollandG.N., SisonR.F., JatulisD.E., HaslopM.G., SakamotoM.J., Wheeler NC and The UCLA CMV Retinopathy Study Group. Survival of patients with the acquired immune deficiency syndrome after development of cytomegalovirus retinopathy. Ophthalmology1990; 97: 204–11.
14.
AccorintiM., CiapparoniV., Colabelli-GisoldiR.A.M., SadunF., RisoD., Pivetti-PezziP.Clinica ed epidemiologia della retinite da cytomegalovirus in corso di AIDS. Boll Ocul1995; 74: 291–300.
