Sanborn G E, Anand R, Torti R E, Nightingale S D, Cal S X, Yates B, Ashton P, Smith T
Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas 75235-9057.
Arch Ophthalmol. 1992 Feb;110(2):188-95. doi: 10.1001/archopht.1992.01080140044023.
A surgically implantable device for sustained intravitreal release of ganciclovir has been developed. The device delivers ganciclovir intraocularly over approximately 4 to 5 months. Eight patients with acquired immunodeficiency syndrome (AIDS) and associated cytomegalovirus (CMV) retinitis were recruited as part of a phase 1 study. Thirteen eyes with active CMV retinitis underwent surgical implantation of the ganciclovir device. All eyes showed resolution of the CMV retinitis; none showed progression. Visual acuity remained unchanged in three eyes, improved in six eyes, and decreased in four eyes. Surgical complications included mild vitreous hemorrhage, astigmatism, and suprachoroidal placement of the device. Retinal detachment occurred in three eyes as the retinitis resolved. This new intraocular drug delivery system offers many advantages compared with intravenous therapy or repeated intravitreal ganciclovir injections for the management of CMV retinitis in patients with AIDS.
一种用于更昔洛韦玻璃体内持续释放的可手术植入装置已被研发出来。该装置可在约4至5个月的时间内将更昔洛韦输送至眼内。作为1期研究的一部分，招募了8名患有获得性免疫缺陷综合征（AIDS）及相关巨细胞病毒（CMV）视网膜炎的患者。13只患有活动性CMV视网膜炎的眼睛接受了更昔洛韦装置的手术植入。所有眼睛的CMV视网膜炎均消退；无一只眼睛病情进展。三只眼睛的视力保持不变，六只眼睛的视力有所改善，四只眼睛的视力下降。手术并发症包括轻度玻璃体出血、散光以及装置置于脉络膜上腔。随着视网膜炎消退，三只眼睛发生了视网膜脱离。与静脉治疗或反复玻璃体内注射更昔洛韦相比，这种新型眼内给药系统在治疗艾滋病患者的CMV视网膜炎方面具有许多优势。
