Abstract
Cytomegalovirus (CMV) retinitis is the most common opportunistic ocular infection in patients with acquired immunodeficiency syndrome (AIDS). Intravenous ganciclovir was the first treatment shown to be efficacious in the management of CMV retinitis. Poor ocular bioavailability prompted the use of intravitreal injection of ganciclovir, foscarnet, and, more recently, cidofovir in order to treat CMV retinitis. The ideal candidate for the ganciclovir implant would be an AIDS patient with newly diagnosed unilateral CMV retinitis with no evidence of systemic CMV. A ganciclovir implant has been used successfully to treat a patient with CMV retinitis caused by profound immuno-suppression after bone marrow transplantation for myeloproliferative disease. In a randomized, controlled clinical trial, the placement of the ganciclovir implant plus orally administered ganciclovir was compared to the use of intravenous cidofovir in 56 eyes of 42 patients, who underwent a total of 74 surgeries for ganciclovir implantation.
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