Abstract

The treatment of cytomegalovirus retinitis (CMV-R) has improved considerably in the past two years. Local ocular therapy has proved to be effective and provides significant advantages over systemic therapy with regards to better control, preventing progression, avoiding bone marrow and renal toxicity. Direct intraocular injections of anti-CMV drugs and the sustained-release ganciclovir device are the mainstay of local therapy. The ganciclovir intraocular device has undergone rigorous testing and has recently been approved for clinical use. This review describes the surgical procedure, recommendations for use, and exchange and management of associated retinal detachment. In addition, the results of the initial studies and the multicenter, randomized clinical trial are discussed. Current data available from the Study for the Ocular Complications of AIDS (SOCA) and AIDS Clinical Trials Group (ACTG) studies are summarized in the context of CMV-R management.

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