Desatnik H R, Foster R E, Lowder C Y
Division of Ophthalmology, Cleveland Clinic Foundation, OH 44195-5024, USA.
Am J Ophthalmol. 1996 Jul;122(1):121-3. doi: 10.1016/s0002-9394(14)71977-4.
To determine the efficacy of combined ganciclovir and foscarnet intravitreal injections in controlling clinically resistant cytomegalovirus retinitis in a 37-year-old man with the acquired immunodeficiency syndrome who refused systemic therapy.
The patient refused systemic therapy and was treated with intravitreal injections of ganciclovir and foscarnet, which were then combined when the retinitis became resistant to either drug alone.
The retinitis was initially controlled with bilateral intravitreal ganciclovir injections. After reactivation of retinitis in the left eye, intravitreal foscarnet was effective until recurrent retinitis threatened the center of the fovea. The retinitis continued to progress until combined intravitreal injections of ganciclovir and foscarnet were administered.
Combined intravitreal injections of ganciclovir and foscarnet may be effective in treating cytomegalovirus retinitis when the infection is clinically resistant to either intravitreal drug alone. Intravitreal injections can be effective in controlling cytomegalovirus retinitis in patients who are intolerant of or refuse systemic therapy.
确定联合玻璃体内注射更昔洛韦和膦甲酸钠对一名37岁患获得性免疫缺陷综合征且拒绝全身治疗的男性患者控制临床耐药性巨细胞病毒性视网膜炎的疗效。
该患者拒绝全身治疗，接受了玻璃体内注射更昔洛韦和膦甲酸钠治疗，当视网膜炎对单一药物产生耐药性时将二者联合使用。
视网膜炎最初通过双侧玻璃体内注射更昔洛韦得到控制。左眼视网膜炎复发后，玻璃体内注射膦甲酸钠有效，直至复发性视网膜炎威胁到黄斑中心凹。视网膜炎持续进展，直至给予玻璃体内联合注射更昔洛韦和膦甲酸钠。
当感染对单一玻璃体内药物产生临床耐药性时，联合玻璃体内注射更昔洛韦和膦甲酸钠可能对治疗巨细胞病毒性视网膜炎有效。玻璃体内注射对不耐受或拒绝全身治疗的患者控制巨细胞病毒性视网膜炎可能有效。
