Treatment of recurrent cytomegaloviru retiniti with the ganciclovir implant Original Reearch Article

PURPOE: To evaluate preoperative characteritic and outcome of the treatment of recurrent cytomegaloviru (CMV) retiniti with the ganciclovir implant. METHOD: Record of 54 patient with acquired immunodeficiency yndrome and active, previouly treated CMV retiniti who received a ganciclovir implant in one (n = 31) or both (n = 23) eye were reviewed. Entry criteria included prior inertion and removal of an indwelling catheter or failure to repond to tolerated doe of ganciclovir and focarnet. Preoperative factor that might correlate with outcome were analyzed, including demographic factor, duration of human immunodeficiency viru dieae and CMV retiniti, indication for urgery, prior anti-CMV treatment, and extent of retiniti. REULT: Forty-ix patient completed 1 month of follow-up and were analyzed for outcome. Thirty-one (67.4%) had inactive retiniti at 1 month v 15 (32.6%) with active retiniti, and they received a mean of 23.5 ± 22.9 week of preoperative ganciclovir v 58.0 ± 52.0 week in patient with active retiniti (P = .003). Involvement of more than 25% of retinal area by CMV retiniti wa alo correlated with activity at 1 month (P < .001). Patient who received implant becaue of lack of venou acce had a median time to progreion of 8.0 ± 3.0 month v 2.0 ± 1.2 month for patient who had inadequate repone or intolerance to intravenou medication (P = .073). Patient with 6 month or le v more than 6 month of preoperative ganciclovir treatment had progreion at a median time of 8.0 ± 1.7 month v 2.0 ± 0.3 month, repectively (P = .016). CONCLUION: Longer duration of preoperative ganciclovir or larger area of CMV retiniti correlate with lower ucce of ganciclovir implant therapy for recurrent retiniti.