Cochereau-Massin I, Lehoang P, Lautier-Frau M, Zazoun L, Marcel P, Robinet M, Matheron S, Katlama C, Gharakhanian S, Rozenbaum W
Department of Ophthalmology, Hôpital Pitié-Salpêtrière, Paris, France.
Ophthalmology. 1991 Sep;98(9):1348-53; discussion 1353-5. doi: 10.1016/s0161-6420(91)32135-3.
Forty-four patients with acquired immune deficiency syndrome with cytomegalovirus (CMV) retinitis (64 eyes) intolerant of or refusing systemic antiviral therapy received 710 intravitreal injections of ganciclovir at the dosage of 400 micrograms per injection. The patients were followed for a mean period of 9 weeks. Induction therapy consisted of two injections a week until healing. Maintenance therapy consisted of one injection a week until relapse. All but 1 of 53 induction courses led to cicatrization, after a mean of 6.6 injections. In 54 maintenance courses, the 8-week relapse rate was 53%. During intravitreal therapy, involvement of the fellow eye occurred in 11% of the patients and CMV infection developed in a nonocular site in 16% of the patients. Five retinal detachments and two intravitreal hemorrhages occurred. No endophthalmitis or cataract was noted. Intravitreal ganciclovir appears to be a safe and effective alternative in patients intolerant of intravenous anti-CMV drugs.
44例患有巨细胞病毒（CMV）视网膜炎的获得性免疫缺陷综合征患者（64只眼），不耐受或拒绝全身抗病毒治疗，接受了710次玻璃体内注射更昔洛韦，每次注射剂量为400微克。患者平均随访9周。诱导治疗包括每周注射两次，直至愈合。维持治疗包括每周注射一次，直至复发。53个诱导疗程中除1个外，其余在平均6.6次注射后均导致瘢痕形成。在54个维持疗程中，8周复发率为53%。在玻璃体内治疗期间，11%的患者对侧眼受累，16%的患者在非眼部部位发生CMV感染。发生了5例视网膜脱离和2例玻璃体内出血。未发现眼内炎或白内障。对于不耐受静脉注射抗CMV药物的患者，玻璃体内注射更昔洛韦似乎是一种安全有效的替代方法。
