They don't want to add up to 12 capsules a day for their patients when it's not clear that they do any good. Two large studies came to different conclusions. There are several issues to consider when choosing a treatment for active CMV disease. Intravenous ganciclovir appears to be the most effective overall CMV treatment. Implants are very effective at stopping retinitis, but only in the eye with the implant.
Pills are the easiest to manage.
While ganciclovir meant up to 12 pills a day, valganciclovir can be as few as 2 a day. Ocular injections mean inserting a needle directly into the eye. Implants, which last six to eight months, take about an hour to insert in an office procedure. CMV retinitis can progress rapidly and lead to blindness. For this reason, it is treated aggressively when it first shows up.