Marx J L, Kapusta M A, Patel S S, LaBree L D, Walonker F, Rao N A, Chong L P
Doheny Eye Institute, Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles, USA.
Arch Ophthalmol. 1996 Jul;114(7):815-20. doi: 10.1001/archopht.1996.01100140029003.
To evaluate the efficacy of the ganciclovir implant in the treatment of recurrent cytomegalovirus (CMV) retinitis.
Patients with acquired immunodeficiency syndrome and recurrent CMV retinitis were evaluated for entry into the study. A ganciclovir implant was inserted in 91 eyes of 70 patients between October 1992 and October 1995. The efficacy of the implant and visual results were retrospectively reviewed.
Fifty-three (76%) of 70 eyes had inactive CMV retinitis 1 month postoperatively (positive initial response). Twenty-one eyes of 19 patients had less than 1 month of follow-up. Nineteen (36%) of 53 eyes developed recurrent CMV retinitis. The median time to recurrence for those patients with a positive initial response was 7 months. Forty-eight (84%) of 57 patients with follow-up longer than 1 month after implant insertion in the first eye received systemic anti-CMV medication during the study. The cumulative risk for developing a retinal detachment was 23% at 6 months following implant insertion. Other complications included vitreous hemorrhage, hyphema, and suprachoroidal implantation of the device.
The ganciclovir implant is effective as an adjunct to continued systemic therapy in those patients with recurrent CMV retinitis.
评估更昔洛韦植入物治疗复发性巨细胞病毒（CMV）视网膜炎的疗效。
对获得性免疫缺陷综合征和复发性CMV视网膜炎患者进行评估以确定是否纳入研究。1992年10月至1995年10月期间，70例患者的91只眼中植入了更昔洛韦植入物。对植入物的疗效和视力结果进行回顾性分析。
70只眼中有53只（76%）在术后1个月时CMV视网膜炎呈静止状态（初始反应阳性）。19例患者的21只眼随访时间不足1个月。53只眼中有19只（36%）发生复发性CMV视网膜炎。初始反应阳性的患者复发的中位时间为7个月。在研究期间，57例在第一眼植入后随访时间超过1个月的患者中有48例（84%）接受了全身性抗CMV药物治疗。植入后6个月时发生视网膜脱离的累积风险为23%。其他并发症包括玻璃体积血、前房积血和植入物脉络膜上腔植入。
对于复发性CMV视网膜炎患者，更昔洛韦植入物作为持续全身治疗的辅助手段是有效的。
