Treatment of cytomegalovirus retinopathy with ganciclovir

Ophthalmology. 1987 Jul;94(7):815-23. doi: 10.1016/s0161-6420(87)33534-1.

Abstract

Ganciclovir is an experimental antiviral drug with activity against human cytomegalovirus (CMV). Forty patients with acquired immune deficiency syndrome (AIDS) and CMV retinopathy were treated with ganciclovir on a compassionate protocol basis. Initial treatment doses ranged from 5.0 to 14.0 mg/kg/day for 9 to 26 days. Signs of drug response were a halt to enlargement of lesions, decreased opacification of retinal tissue, and resolution of hemorrhage and vasculitis. Complete response was seen in 88% of patients and incomplete response was seen in 9%. Vision improved or remained stable in 88% of patients. Initial treatment did not eradicate live virus from the eye. To prevent reactivation of disease, 26 patients received low-dose maintenance therapy ranging from 1.5 to 7.5 mg/kg/day, once or twice daily, 3 to 7 days per week. Reactivation of disease developed for unknown reasons in 50% of patients on continuous, uninterrupted maintenance therapy for longer than 3 weeks. Reversible neutropenia, requiring cessation of treatment, developed in 30% of patients on initial treatment and in 38% of patients on maintenance therapy. Rhegmatogenous retinal detachment was a late complication in seven patients. By reducing or delaying visual loss, ganciclovir appears to be useful in the management of CMV retinopathy in patients with AIDS.

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications
  • Acyclovir / administration & dosage
  • Acyclovir / adverse effects
  • Acyclovir / analogs & derivatives*
  • Acyclovir / therapeutic use
  • Adult
  • Cytomegalovirus Infections / complications
  • Cytomegalovirus Infections / drug therapy*
  • Cytomegalovirus Infections / pathology
  • Cytomegalovirus Infections / physiopathology
  • Female
  • Ganciclovir
  • Humans
  • Male
  • Middle Aged
  • Neutropenia / chemically induced
  • Retina / pathology
  • Retinal Diseases / complications
  • Retinal Diseases / drug therapy*
  • Retinal Diseases / pathology
  • Retinal Diseases / physiopathology
  • Vision, Ocular

Substances

  • Ganciclovir
  • Acyclovir