Document 2906
 DOCN  M94A2906
 TI    Maintenance therapy of cytomegalovirus retinitis with intravitreal
       injection only: safety and effectiveness.
 DT    9412
 AU    Pastor M; Viciana P; Calvo R; Nuno E; Seva E; Rodriguez MJ; Ophtalmology
       Departament, Hospital V. Ricio, Seville, Spain.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):198 (abstract no. PB0220). Unique
       Identifier : AIDSLINE ICA10/94369669
 AB    OBJECTIVE: To determine the safety and effectiveness of maintenance
       therapy of cytomegalovirus (CMV) retinitis with intravitreal injections,
       without intravenous maintenance therapy in AIDS patients. METHODS: After
       complications with in-dwelling central lines, and the lost of
       quality-life with the intravenous maintenance therapy, we resolve to use
       only the intravitreal route. Patient evolutions were evaluated. After
       inductions, a weekly injection of ganciclovir (G) or foscarnet (F) was
       done. We analized the rate and the median time of reactivations, the
       need of reinduction therapy, lost of visual acuity, survival, and
       complications of intraocular injections. RESULTS: We evaluated a total
       of 513 injections in 18 eyes of 17 patients. The induced therapy was
       intravenous with Ganciclovir (G) or Foscarnet (F) in 7, intravitreal in
       5, and in the other 5 we used a combined induction therapy. The initial
       response were progression in 3 and resolution in 14. The mean time of
       maintenance therapy post-induction was 28.8 +/- 31 weeks (range 5-120).
       Progression appeared in 12(66%) eyes, in a mean time of 13.7 weeks, but
       only in 4 patients the CMV retinitis progressed to a total visual lost,
       in a mean of 30 weeks, in three of them due to optic neuritis. The other
       eyes maintained a good visual acuity, in spite of the progression of the
       retinitis. 10 patients died in the follow-up, with a mean survival time
       of 26.8 +/- 23 weeks (range 7-86). Complications occurred in 2 patients,
       one retinal detachments and vitreitis in the other. CONCLUSION: The
       intravitreal injections is a safe treatment of maintenance in CMV
       retinitis, it was effective to avoid visual loss, except when the
       patients had optic neuritis. The intravitreal therapy allows better
       quality of life.
 DE    AIDS-Related Opportunistic Infections/*DRUG THERAPY  Cytomegalovirus
       Retinitis/COMPLICATIONS/*DRUG THERAPY  Evaluation Studies
       Foscarnet/*ADMINISTRATION & DOSAGE  Ganciclovir/*ADMINISTRATION & DOSAGE
       Human  Injections  Optic Neuritis/ETIOLOGY  Retinal Detachment/ETIOLOGY
       Survival Analysis  Visual Acuity  *Vitreous Body  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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