J Korean Ophthalmol Soc.  2016 Feb;57(2):316-323. 10.3341/jkos.2016.57.2.316.

Safety and Efficacy of Intravitreal Ganciclovir Injections More than 10 Times for Cytomegalovirus Retinitis

• Jang KH
• Heo JW

• KMID: 2213675
• DOI: http://doi.org/10.3341/jkos.2016.57.2.316

Abstract

PURPOSE
To study the treatment outcomes in patients who were administered multiple intravitreal ganciclovir injections more than 10 times alone without systemic anti-cytomegalovirus therapy for cytomegalovirus retinitis.
CASE SUMMARY
A 64-year-old man who underwent immunosuppressive therapy after thymectomy due to an invasive thymoma and pure red-cell aplasia, a 60-year-old woman who underwent chemotherapy after diagnosis of diffuse large B-cell lymphoma, a 49-year-old man with a history of bone marrow transplantation due to acute myeloid leukemia, a 29-year-old woman with dermatomyositis treated with oral steroids and cyclosporine, and a 47-year-old woman who received intravitreal dexamethasone implant injections, intravitreal and subtenon steroid injections due to Behcet's disease were diagnosed with cytomegalovirus retinitis. All patients showed systemic complications such as pancytopenia after systemic anti-cytomegalovirus therapy, and therefore, they were administered multiple intravitreal ganciclovir injections alone. Best-corrected visual acuities improved in all patients, except in one case, where viral lesions were observed in the fovea. Retinal hemorrhaging and infiltrative lesions decreased in all patients. No severe complication was observed during the injection and in the follow-up period.
CONCLUSIONS
Multiple intravitreal ganciclovir injections alone can be used as a treatment modality for cytomegalovirus retinitis to avoid the systemic side effects of systemic anti-cytomegalovirus therapy.

Keyword

Cytomegalovirus retinitis; Intravitreal ganciclovir injection; Multiple intravitreal ganciclovir injection

MeSH Terms

Adult
Bone Marrow Transplantation
Cyclosporine
Cytomegalovirus Retinitis*
Cytomegalovirus*
Dermatomyositis
Dexamethasone
Diagnosis
Drug Therapy
Female
Follow-Up Studies
Ganciclovir*
Humans
Intravitreal Injections
Leukemia, Myeloid, Acute
Lymphoma, B-Cell
Middle Aged
Pancytopenia
Red-Cell Aplasia, Pure
Retinaldehyde
Steroids
Thymectomy
Thymoma
Visual Acuity
Cyclosporine
Dexamethasone
Ganciclovir
Retinaldehyde
Steroids