Treatment of Cytomegalovirus Retinitis in AIDS with Intravitreal Foscanet and Ganciclovir Injection

Passorn Preechawai, M.D.
Sunun Kasertkalam, BS.C.
Mansing Ratanasukon, M.D.
Anuchit Kittantong M.D.

ABSTRACT :

Objective : To compare the treatment outcome and complications of intravitreous ganciclovir and foscanet injection for treating cytomegalovirus retinitis in HIV patients.

Design : Retrospective comparative study

Methods : The HIV patients with cytomegalovirus retinitis (65 pts, 103 eyes) were retrospective reviewed. The patients were divided into two treatment groups which were intravitreal foscanet and ganciclovir injection. The outcomes were assessed by demographic datas, pre and post operative visual acuity, duration of HIV infection, opportunistic infections, highly active antiretroviral therapy, duration of blurred vision, duration of retinitis in the fellow eye, type and zone of lesions, treatment outcomes by response criteria (complete response, partial response, no response, or recurrent), duration of improvement and complications of the procedure or the disease. Results : The results demonstrated ganciclovir group received highly active antiretroviral therapy more than foscanet group and the duration or recurrent was also longer. The treatment outcomes by response criteria were not statistically significant in both. Gancicnilovir group with complete response was 63.22%, foscanet group was 43.75%. Partial response in gan-ciclovir group was 23%, foscanet group was 37.50%. No response were 13.79%, 18.75% and recurrent were 14.94% and 25.00% respectively. The complications of the diseases and treatment were not statistically different.

Conclusion : The treatment efficacy and complication of cytomegalovirus retinitis in AIDS patients with intravitreous ganciclovir and foscanet injection were not statistically different. The patients who received HAART showed significantly longer duration of recurrent.

Thai J Ophthalmol 2003 ; July-December 17(2) : 125-137. Ke

y words : cytomegalovirus retinitis, acquired immune deficiency syndrome, ganciclovir, foscanet.