TREATMENT OF CYTOMEGALO-VIRUS RETINITIS WITH INTRAVITREAL GANCICLOVIR - LONG-TERM RESULTS
TREATMENT OF CYTOMEGALO-VIRUS RETINITIS WITH INTRAVITREAL GANCICLOVIR - LONG-TERM RESULTS
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DOI：
10.1016/s0161-6420(89)32900-9
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发表时间：
1989-03-01
期刊：
影响因子：
13.7
通讯作者：
BALFOUR, HH
中科院分区：
文献类型：
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作者：
CANTRILL, HL;HENRY, K;BALFOUR, HH
对10例获得性免疫缺陷综合征（AIDS）患者进行了玻璃体腔注射更昔洛韦（Ganciclovir）治疗巨细胞病毒（CMV）视网膜炎的长期观察。患者不能耐受全身更昔洛韦，因为严重的中性粒细胞减少症（8例），导管诱导的脓毒症（1例），或需要继续治疗人类免疫缺陷病毒（HIV）与齐多夫定（ZDV）（1例）。所有患者对初始治疗均有良好反应。巨细胞病毒视网膜炎进展的四个同伴的眼睛，其中治疗被推迟。除了一只眼睛外，所有眼睛的视力都得到改善或保持稳定。患者平均随访4个月，每只眼睛平均接受16.6次玻璃体内注射。5只眼（33%）在维持治疗期间复发。没有证据表明重复玻璃体内注射有毒性。治疗耐受性良好。在总共249次注射中，唯一的严重并发症是一例表皮葡萄球菌性眼内炎，对玻璃体内抗生素治疗有反应。玻璃体注射更昔洛韦是一种有效的替代全身更昔洛韦在这些患者严重中性粒细胞减少症和那些谁希望保持全身ZDV。
Long-term management of cytomegalovirus (CMV) retinitis by Intravitreal injection of ganciclovir was evaluated in ten patients with acquired immune deficiency syndrome (AIDS). Patients were unable to tolerate systemic ganciclovir because of severe neutropenia (8 cases), catheter-induced sepsis (1 case), or the need to continue therapy for human immunodeficiency virus (HIV) with zidovudine (ZDV) (1 case). All patients had a favorable response to initial treatment. Cytomegalovirus retinitis progressed in four fellow eyes in which treatment was deferred. Vision improved or remained stable in all but one eye. Patients were followed for a mean of 4 months and received an average of 16.6 intravitreal injections in each eye. Relapse occurred late in the course while on maintenance treatment in five eyes (33%). There was no evidence of toxicity from repeated intravitreal injections. Treatment was very well tolerated. The only severe complication in a total of 249 injections was a single case ofStaphylococcus epidermidisendophthalmitis which responded to intravitreal antibiotic treatment. Intravitreal ganciclovir is an effective alternative to systemic ganciclovir in those patients with severe neutropenia and in those patients who desire to remain on systemic ZDV.