Rosecan L R, Laskin O L, Kalman C M, Haik B G, Ellsworth R M
Ophthalmology. 1986 Nov;93(11):1401-7. doi: 10.1016/s0161-6420(86)33557-7.
A child with bilateral cytomegalovirus (CMV) retinitis, vitritis, and exudative retinal detachments, who was in remission from stage IV neuroblastoma and status post-chemotherapy and autologous bone marrow transplantation, was treated with ganciclovir. The drug is a new acyclic nucleoside antiviral drug with potent antiCMV activity. There was bilateral retinal reattachment, clearing of vitritis and regression of retinal exudates and hemorrhages, with concomitant resolution of viral shedding in urine and blood, on ganciclovir 7.5 mg/kg per day. There was recurrence of exudative detachments, vitritis and retinitis when the dose was reduced to 2.5 mg/kg per day, and regression of these findings when the dose was again increased to 7.5 mg/kg per day. Despite continued therapy at this dose, a relapse occurred. When the dose of drug was doubled to 15 mg/kg per day, there initially was a partial therapeutic response, followed by a subsequent relapse. No further response was seen when the dose was increased to 19.5 mg/kg per day. This patient was treated with ganciclovir for a total of 192 days. No adverse reactions to ganciclovir were seen. On the last day of drug administration, there were persistent bilateral exudative retinal detachments and progressive optic nerve head involvement with optic disc pallor, despite quiescence of the retinitis.
一名患有双侧巨细胞病毒（CMV）视网膜炎、玻璃体炎和渗出性视网膜脱离的儿童，处于IV期神经母细胞瘤缓解期，已接受化疗和自体骨髓移植，接受了更昔洛韦治疗。该药物是一种新型无环核苷抗病毒药物，具有强大的抗CMV活性。每天使用7.5mg/kg的更昔洛韦时，双侧视网膜复位，玻璃体炎消退，视网膜渗出和出血减轻，同时尿液和血液中的病毒排出也得到缓解。当剂量降至2.5mg/kg/天时，渗出性视网膜脱离、玻璃体炎和视网膜炎复发，而当剂量再次增加至7.5mg/kg/天时，这些症状又有所缓解。尽管以该剂量持续治疗，但仍出现了复发。当药物剂量加倍至15mg/kg/天时，最初有部分治疗反应，随后又复发。当剂量增加至19.5mg/kg/天时，未见进一步反应。该患者总共接受了192天的更昔洛韦治疗。未观察到对更昔洛韦的不良反应。在给药的最后一天，尽管视网膜炎已静止，但仍存在双侧持续性渗出性视网膜脱离，并且视神经乳头受累进展，出现视盘苍白。
