gms | German Medical Science

Background: We compared different treatments of CMV-retinitis in immunocompromised, immunocompetent and HIV-infected individuals.

Methods: In a non-randomised, retrospective, interventional, non-comparative case series patients with CMV-retinitis were reviewed. Between 1996 and 2009 a cohort of 7 patients/9 eyes received intravitreal ganciclovir (3 mg/0.1 ml) and 8 patients/10 eyes received a ganciclovir implant.

Results: Follow-up ranged between 3 and 124 months (mean 20.47). An average number of 6.6 injections of ganciclovir (between 2 and 28) were necessary to treat CMV-retinitis. The mean visual acuity dropped by 8 lines from logmar 0.54 to logmar 1.3056 at final visit. In the injection group 4 of 9 eyes showed retinal detachment in the course of the disease and two eyes developed amaurosis.None of 10 eyes of the ganciclovir implant group showed retinal detachment, but 1 of 10 eyes must be treated due to vitreous bleeding, 1 of 10 eyes had to be enucleated and 1 out of 10 eyes were operated due to macular pucker. 2 out of 10 eyes developed amaurosis. In the group of patients treated with ganciclovir implants only 1 patient needed more than one implant. Mean visual acuity dropped by 8 lines from logmar 0.34 to logmar 1.1 at final visit.

Conclusion: No treatment was more favourable than the other. Just in two cases, one in the implant and one in the injection group, visual acuity improved. The main complication in this disease is retinal detachment. We advise prompt diagnosis and treatment of the disease with frequent controls even after inflammation stopped.