Intravitreal gancyclovir for the induction and maintenance therapy of CMV retinitis - Reactivation rates and time to progression

Abstract

Purpose. To assess reactivation rates and time to progression for patients treated with intravitreal gancyclovir for the induction and maintenance therapy of CMV retinitis. Methods. A retrospective chart review was done on patients treated exclusivally with intravitreal gancyclovir at McGill University between 1991 and 1994. Results. 39 patients received intravitreal gancyclovir during the study period. 19/ 36 (53%) patients had a primary recurrence, an average of 123.6d following initial induction therapy. 9/17 (53%) patients had a secondary recurrence, an average of 87.1d following reinduction therapy. 4/6 (66%) patients had a tertiary recurrence, an average of 34.1d following secondary reinduction. Second eye involvement was 36%, systemic CMV disease occured in 6%, and ocular complications occured in 15%. Conclusion. The time to recurrence with intravitreal gancylovir therapy accelerates over time. Reactivation rates, time to recurrence, ocular complications and second eye involvement with intravitreal gancylovir therapy are comparable with standard intravenous therapy.