Skip to main content
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1988 Jul;72(7):525–529. doi: 10.1136/bjo.72.7.525

Treatment of cytomegalovirus retinitis with ganciclovir (9-[2-hydroxy-1-(hydroxymethyl) ethoxymethyl] guanine (BW B759U).

J Orellana 1, S A Teich 1, J S Winterkorn 1, U Mathur-Wagh 1, S Handwerger 1, H Schlamm 1, S C Malamud 1, S R Yancovitz 1, D M Cederberg 1, D S Mildvan 1
PMCID: PMC1041518  PMID: 2843219

Abstract

Six patients (11 eyes) with virologically confirmed cytomegalovirus (CMV) retinitis involving the posterior pole of the eye were treated with a new drug, ganciclovir. Treatment with intravenous ganciclovir consistently halted progression of retinitis and produced improvement in measures of visual function. However, within three weeks after cessation of therapy renewed CMV activity and worsening of visual function were observed in most cases. Maintenance therapy with ganciclovir extended the period of remission from CMV retinitis.

Full text

PDF
525

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aaberg T. M., Cesarz T. J., Rytel M. W. Correlation of virology and clinical course of cytomegalovirus retinitis. Am J Ophthalmol. 1972 Sep;74(3):407–415. doi: 10.1016/0002-9394(72)90899-9. [DOI] [PubMed] [Google Scholar]
  2. Augsburger J. J., Henry R. Y. Retinal aneurysms in adult cytomegalovirus retinitis. Am J Ophthalmol. 1978 Dec;86(6):794–797. doi: 10.1016/0002-9394(78)90123-x. [DOI] [PubMed] [Google Scholar]
  3. BURNS R. P. Cytomegalic inclusion disease uveitis; report of a case with isolation from aqueous humor of the virus in tissue culture. AMA Arch Ophthalmol. 1959 Mar;61(3):376–387. [PubMed] [Google Scholar]
  4. Bach M. C., Bagwell S. P., Knapp N. P., Davis K. M., Hedstrom P. S. 9-(1,3-Dihydroxy-2-propoxymethyl)guanine for cytomegalovirus infections in patients with the acquired immunodeficiency syndrome. Ann Intern Med. 1985 Sep;103(3):381–382. doi: 10.7326/0003-4819-103-3-381. [DOI] [PubMed] [Google Scholar]
  5. Berger B. B., Weinberg R. S., Tessler H. H., Wyhinny G. J., Vygantas C. M. Bilateral cytomegalovirus panuveitis after high-dose corticosteroid therapy. Am J Ophthalmol. 1979 Dec;88(6):1020–1025. doi: 10.1016/0002-9394(79)90409-4. [DOI] [PubMed] [Google Scholar]
  6. Broughton W. L., Cupples H. P., Parver L. M. Bilateral retinal detachment following cytomegalovirus retinitis. Arch Ophthalmol. 1978 Apr;96(4):618–619. doi: 10.1001/archopht.1978.03910050314003. [DOI] [PubMed] [Google Scholar]
  7. Chumbley L. C., Robertson D. M., Smith T. F., Campbell R. J. Adult cytomegalovirus inclusion retino-uveitis. Am J Ophthalmol. 1975 Nov;80(5):807–816. doi: 10.1016/0002-9394(75)90276-7. [DOI] [PubMed] [Google Scholar]
  8. Cogan D. G. Immunosuppression and eye disease. First Vail lecture. Am J Ophthalmol. 1977 Jun;83(6):777–788. doi: 10.1016/0002-9394(77)90903-5. [DOI] [PubMed] [Google Scholar]
  9. Cox F., Meyer D., Hughes W. T. Cytomegalovirus in tears from patients with normal eyes and with acute cytomegalovirus chorioretinitis. Am J Ophthalmol. 1975 Nov;80(5):817–824. doi: 10.1016/0002-9394(75)90277-9. [DOI] [PubMed] [Google Scholar]
  10. Drew W. L., Mintz L., Miner R. C., Sands M., Ketterer B. Prevalence of cytomegalovirus infection in homosexual men. J Infect Dis. 1981 Feb;143(2):188–192. doi: 10.1093/infdis/143.2.188. [DOI] [PubMed] [Google Scholar]
  11. Felsenstein D., D'Amico D. J., Hirsch M. S., Neumeyer D. A., Cederberg D. M., de Miranda P., Schooley R. T. Treatment of cytomegalovirus retinitis with 9-[2-hydroxy-1-(hydroxymethyl)ethoxymethyl]guanine. Ann Intern Med. 1985 Sep;103(3):377–380. doi: 10.7326/0003-4819-103-3-377. [DOI] [PubMed] [Google Scholar]
  12. Freeman W. R., Lerner C. W., Mines J. A., Lash R. S., Nadel A. J., Starr M. B., Tapper M. L. A prospective study of the ophthalmologic findings in the acquired immune deficiency syndrome. Am J Ophthalmol. 1984 Feb;97(2):133–142. doi: 10.1016/s0002-9394(14)76082-9. [DOI] [PubMed] [Google Scholar]
  13. Friedman A. H., Orellana J., Freeman W. R., Luntz M. H., Starr M. B., Tapper M. L., Spigland I., Roterdam H., Mesa Tejada R., Braunhut S. Cytomegalovirus retinitis: a manifestation of the acquired immune deficiency syndrome (AIDS). Br J Ophthalmol. 1983 Jun;67(6):372–380. doi: 10.1136/bjo.67.6.372. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Gottlieb M. S., Schroff R., Schanker H. M., Weisman J. D., Fan P. T., Wolf R. A., Saxon A. Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: evidence of a new acquired cellular immunodeficiency. N Engl J Med. 1981 Dec 10;305(24):1425–1431. doi: 10.1056/NEJM198112103052401. [DOI] [PubMed] [Google Scholar]
  15. Holland G. N., Pepose J. S., Pettit T. H., Gottlieb M. S., Yee R. D., Foos R. Y. Acquired immune deficiency syndrome. Ocular manifestations. Ophthalmology. 1983 Aug;90(8):859–873. doi: 10.1016/s0161-6420(83)80009-8. [DOI] [PubMed] [Google Scholar]
  16. Hymes K. B., Cheung T., Greene J. B., Prose N. S., Marcus A., Ballard H., William D. C., Laubenstein L. J. Kaposi's sarcoma in homosexual men-a report of eight cases. Lancet. 1981 Sep 19;2(8247):598–600. doi: 10.1016/s0140-6736(81)92740-9. [DOI] [PubMed] [Google Scholar]
  17. Keith C. G., La Nauze J. Cytomegalovirus retinitis. Med J Aust. 1980 Jan 12;1(1):24–26. doi: 10.5694/j.1326-5377.1980.tb134569.x. [DOI] [PubMed] [Google Scholar]
  18. Khadem M., Kalish S. B., Goldsmith J., Fetkenhour C., O'Grady R. B., Phair J. P., Chrobak M. Ophthalmologic findings in acquired immune deficiency syndrome (AIDS). Arch Ophthalmol. 1984 Feb;102(2):201–206. doi: 10.1001/archopht.1984.01040030151015. [DOI] [PubMed] [Google Scholar]
  19. Mar E. C., Cheng Y. C., Huang E. S. Effect of 9-(1,3-dihydroxy-2-propoxymethyl)guanine on human cytomegalovirus replication in vitro. Antimicrob Agents Chemother. 1983 Oct;24(4):518–521. doi: 10.1128/aac.24.4.518. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Masur H., Lane H. C., Palestine A., Smith P. D., Manischewitz J., Stevens G., Fujikawa L., Macher A. M., Nussenblatt R., Baird B. Effect of 9-(1,3-dihydroxy-2-propoxymethyl) guanine on serious cytomegalovirus disease in eight immunosuppressed homosexual men. Ann Intern Med. 1986 Jan;104(1):41–44. doi: 10.7326/0003-4819-104-1-41. [DOI] [PubMed] [Google Scholar]
  21. Mildvan D., Mathur U., Enlow R. W., Romain P. L., Winchester R. J., Colp C., Singman H., Adelsberg B. R., Spigland I. Opportunistic infections and immune deficiency in homosexual men. Ann Intern Med. 1982 Jun;96(6 Pt 1):700–704. doi: 10.7326/0003-4819-96-6-700. [DOI] [PubMed] [Google Scholar]
  22. Newsome D. A., Green W. R., Miller E. D., Kiessling L. A., Morgan B., Jabs D. A., Polk B. F. Microvascular aspects of acquired immune deficiency syndrome retinopathy. Am J Ophthalmol. 1984 Nov;98(5):590–601. doi: 10.1016/0002-9394(84)90245-9. [DOI] [PubMed] [Google Scholar]
  23. Nicholson D. H. Cytomegalovirus infection of the retina. Int Ophthalmol Clin. 1975 Winter;15(4):151–162. doi: 10.1097/00004397-197501540-00013. [DOI] [PubMed] [Google Scholar]
  24. Palestine A. G., Rodrigues M. M., Macher A. M., Chan C. C., Lane H. C., Fauci A. S., Masur H., Longo D., Reichert C. M., Steis R. Ophthalmic involvement in acquired immunodeficiency syndrome. Ophthalmology. 1984 Sep;91(9):1092–1099. doi: 10.1016/s0161-6420(84)34201-4. [DOI] [PubMed] [Google Scholar]
  25. Palestine A. G., Stevens G., Jr, Lane H. C., Masur H., Fujikawa L. S., Nussenblatt R. B., Rook A. H., Manischewitz J., Baird B., Megill M. Treatment of cytomegalovirus retinitis with dihydroxy propoxymethyl guanine. Am J Ophthalmol. 1986 Jan 15;101(1):95–101. doi: 10.1016/0002-9394(86)90470-8. [DOI] [PubMed] [Google Scholar]
  26. Pollard R. B., Egbert P. R., Gallagher J. G., Merigan T. C. Cytomegalovirus retinitis in immunosuppressed hosts. I. Natural history and effects of treatment with adenine arabinoside. Ann Intern Med. 1980 Nov;93(5):655–664. doi: 10.7326/0003-4819-93-5-655. [DOI] [PubMed] [Google Scholar]
  27. Rosecan L. R., Stahl-Bayliss C. M., Kalman C. M., Laskin O. L. Antiviral therapy for cytomegalovirus retinitis in AIDS with dihydroxy propoxymethyl guanine. Am J Ophthalmol. 1986 Apr 15;101(4):405–418. doi: 10.1016/0002-9394(86)90638-0. [DOI] [PubMed] [Google Scholar]
  28. Teich S. A., Tay S., Friedman A. H., Schmitterer M. E. Viral particles in the conjunctiva of a patient with the acquired immune deficiency syndrome. Am J Med. 1987 Jan;82(1):151–152. doi: 10.1016/0002-9343(87)90395-0. [DOI] [PubMed] [Google Scholar]
  29. Tocci M. J., Livelli T. J., Perry H. C., Crumpacker C. S., Field A. K. Effects of the nucleoside analog 2'-nor-2'-deoxyguanosine on human cytomegalovirus replication. Antimicrob Agents Chemother. 1984 Feb;25(2):247–252. doi: 10.1128/aac.25.2.247. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Wyhinny G. J., Apple D. J., Guastella F. R., Vygantas C. M. Adult cytomegalic inclusion retinitis. Am J Ophthalmol. 1973 Nov;76(5):773–781. doi: 10.1016/0002-9394(73)90576-x. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES