Intraocular Antiviral Therapy

Abstract

In this issue of theArchives, Heinemann 1 reports the results of long-term intravitreal ganciclovir injection therapy for patients with acquired immunodeficiency syndrome (AIDS) with cytomegalovirus (CMV) retinitis. As the AIDS epidemic has grown to affect all population centers in this country, ophthalmologists have more frequently been encountering and treating patients with CMV retinitis. Recently the Food and Drug Administration approved the use of intravenous ganciclovir after reviewing a large body of reports, largely by ophthalmologists, of the efficacy of this drug in patients with AIDS with CMV retinitis. The enthusiasm for ganciclovir stems not from an extraordinarily high clinical success rate or ease of use but rather from the inexorable progression of untreated CMV retinitis, with resulting blindness. 2-4 Clinicians using ganciclovir therapy are confronted with many serious difficulties, including frequent bone marrow toxicity most commonly manifested by neutropenia (absolute neutrophil count