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M94A2906.TXT
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1994-10-25
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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
protected by Copyright Law (Title 17, U.S.Code).