These efforts are beginning to pay off, although nothing close to an optimally safe and effective treatment has been achieved. An oral form of ganciclovir has been available for some time now. For many patients, the convenience of oral delivery may be the deciding factor. Oral ganciclovir therapy is probably adequate therapy for patients with lesions that do not threaten the optic disc or the fovea, the part of the retina most critical for visual acuity, but for patients with central lesions, oral ganciclovir alone does not provide sufficient protection. The ganciclovir implant offers the most efficacy of any initial treatment for CMV retinitis, probably due to the high concentrations of drug that it delivers to the inner eye.
Implants contain enough ganciclovir to last about eight months.
The implants need to be placed surgically, however, and the procedure may contribute to retinal detachment. Ganciclovir is also available as an intraocular implant. The implant offers the most efficacy of any initial treatment for CMV retinitis, probably due to the high concentrations of drug that it delivers to the inner eye. Implants contain enough ganciclovir to last about eight months. However, certain risks do accompany this treatment option.