Table 2.

Clinical details of patients undergoing ganciclovir-resistance evaluation using ocular fluid

Pt/Age/Sex	Associated medical conditions	Months of valganciclovir or ganciclovir prior to CMV reactivation†	Presence of point mutations in CMV UL97 or UL54 genes associated with ganciclovir- resistance?	CMV retinitis treatment prior to ganciclovir- resistance testing	Change in therapy?
1/73/M	Natural killer cell leukemia	> 12	Yes (9/2008) – UL97: C592G*; UL54: T503I*; No (1/2008)	Valganciclovir	Yes, intravitreal foscarnet
2/67/F	Lung transplant, mycophenolate mofetil, prednisone, tacrolimus	> 12	Yes – UL97: M460I*; UL54: A987G* UL54 mutations identified but not associated with ganciclovir-resistance: S655L, N685S, A885T, N898D	Valganciclovir	Yes, intravitreal and intravenous foscarnet
3/32/M	HIV	1	No	Valganciclovir, intravitreal foscarnet	No
4/41/M	HIV	2, poorly compliant with valganciclovir	No**	Valganciclovir, intravitreal foscarnet	No, ganciclovir implant both eyes due to poor medication compliance
5/10 mo/M	Acute lymphocytic leukemia	2	No	Intravenous foscarnet/ganciclovir, Intravitreal foscarnet	No
6/72/F	Diabetes mellitus	6	No	Valganciclovir, intravitreal foscarnet	No

^†CMV reactivation was confirmed with positive CMV PCR with both qualitative and quantitive real-time PCR (data not shown). HSV, VZV, and toxoplasmosis DNA of ocular fluids were negative for all patients. Aqueous humor specimens were obtained in patients 1–5 and a vitreous specimen was obtained in patient 6.

^*UL97 or UL54 point mutations associated with ganciclovir-resistance

^**No UL97 mutations conferring resistance, UL54 base changes identified but none know to confer phenotypic resistance