Intravitreal Foscarnet for Cytomegalovirus Retinitis in Patients with AIDS
Somsanguan Ausayakhun, MD, MHSc *, Sopa Watananikorn, MD* Suphop Ngamtiphakorn, PN*, Jeradech Prasitsilp, PN*
Affiliation : * Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai
To determine the visual outcome, progression, and complications of patients with acquired immuno- deficiency syndrome-related cytomegalovirus (CMV) retinitis treated with intravitreal foscarnet (2.4 mg in 0.1 ml per injection), a retrospective study was carried out in 193 patients. Induction therapy consisted of two injections a week until the lesions were inactive. Maintenance therapy consisted of one injection a week until relapse, then re-induction was instituted. In 301 treated eyes, visual acuity remained stable in 184 (61%), improved in 16 (5%), and decreased in 101 (34%). Of these, 15 retinal detachments, 13 intravitreal hemorrhages, 3 endophthalmitis, and 2 cataract occurred. Median time of first progression was 15 weeks. Involvement of the fellow eye occurred in 35% of the patients during treatment of the first eye. Intravitreal foscarnet appeared to be a useful alternative treatment for patients intolerant or unaffordable to intravenous anti-CMV drugs, but the complications of this treatment should also be considered.
Keywords : Acquired Immunodeficiency Syndrome (AIDS), Cytomegalovirus (CMV), Retinitis, Foscarnet, Intravitreal injection
