Treatment of Cytomegalovirus Retinitis in Patients with AIDS
Authors: Douglas A. Jabs
Journal: Annals of Internal Medicine (1996)

Editorials15 July 1996Treatment of Cytomegalovirus Retinitis in Patients with AIDSDouglas A. Jabs, MDDouglas A. Jabs, MDWilmer Eye Institute, Baltimore, MD 21205Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-2-199607150-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Cytomegalovirus (CMV) is among the most common opportunistic infections in patients with the acquired immunodeficiency syndrome (AIDS) [1-3]. In the era of prophylaxis for Pneumocystis carinii pneumonia, disease caused by CMV has been reported to affect as many as 45% of patients with AIDS at some time during the course of disease [2]. Although CMV may affect the eyes, gastrointestinal tract, lungs, and central nervous system, CMV retinitis accounts for 85% of all CMV disease in patients with AIDS [3]. Untreated CMV retinitis spreads through the retina and causes total retinal destruction and blindness [4, 5]. Hence, CMV retinitis is ...References1. Moore RD, Chaisson RE. Natural history of opportunistic disease in an HIV-infected urban clinical cohort. Ann Intern Med. 1996; 124:633-42. Google Scholar2. Hoover DR, Saah AJ, Bacellar H, Phair J, Detels R, Anderson R, et al. Clinical manifestations of AIDS in the era of Pneumocystis prophylaxis. Multicenter AIDS Cohort Study. N Engl J Med. 1993; 329:1922-6. Google Scholar3. Gallant JE, Moore RD, Richman DD, Keruly J, Chaisson RE. Incidence and natural history of cytomegalovirus disease in patients with advanced human immunodeficiency virus disease treated with zidovudine. The Zidovudine Epidemiology Study Group. J Infect Dis. 1992; 166:1223-7. Google Scholar4. Jabs DA, Enger C, Bartlett JG. Cytomegalovirus retinitis and acquired immunodeficiency syndrome. Arch Ophthalmol. 1989; 107:75-80. Google Scholar5. Jabs DA. Ocular manifestations of HIV infection. Trans Am Ophthalmol Soc. 1995; 93:623-83. Google Scholar6. Pepose JS, Newman C, Bach MC, Quinn TC, Ambinder RF, Holland GN, et al. Pathologic features of cytomegalovirus retinopathy after treatment with the antiviral agent ganciclovir. Ophthalmology. 1987; 94:414-24. Google Scholar7. Spector SA, Weingeist T, Pollard RB, Dietreich DT, Samo T, Benson CA, et al. A randomized, controlled study of intravenous ganciclovir therapy for cytomegalovirus peripheral retinitis in patients with AIDS. J Infect Dis. 1993; 168:557-63. Google Scholar8. Palestine AG, Polis MA, De Smet MD, Baird BF, Falloon J, Kovacs JA, et al. A randomized, controlled trial of foscarnet in the treatment of cytomegalovirus retinitis in patients with AIDS. Ann Intern Med. 1991; 115:665-73. Google Scholar9. Foscarnet-Ganciclovir Cytomegalovirus Retinitis Trial. 4. Visual Outcomes. Studies of Ocular Complications of AIDS Research Group in collaboration with the AIDS Clinical Trials Group. Ophthalmology. 1994; 101:1250-61. Google Scholar10. Mortality in patients with the acquired immunodeficiency syndrome treated with either foscarnet or ganciclovir for cytomegalovirus retinitis. Studies of Ocular Complications of AIDS Research Group in collaboration with the AIDS Clinical Trials Group. N Engl J Med. 1992; 326:213-220. Google Scholar11. Masur H, Whitcup SM, Cartwright C, Polis M, Nussenblatt R. Advances in the management of AIDS-related cytomegalovirus retinitis. Ann Intern Med. 1996; 125:126-36. Google Scholar12. Intravenous versus oral ganciclovir: European/Australian comparative study of efficacy and safety in the prevention of cytomegalovirus retinitis recurrence in patients with AIDS. The Oral Ganciclovir European and Australian Cooperative Study Group. AIDS. 1995; 9:471-7. Google Scholar13. Drew WL, Ives D, Lalezari JP, Crumpacker C, Follansbee SE, Spector SA, et al. Oral ganciclovir as maintenance treatment for cytomegalovirus retinitis in patients with AIDS. N Engl J Med. 1995; 333:615-20. Google Scholar14. Combination foscarnet and ganciclovir therapy vs monotherapy for the treatment of relapsed cytomegalovirus retinitis in patients with AIDS. Studies of Ocular Complications of AIDS Research Group in collaboration with the AIDS Clinical Trials Group. Arch Ophthalmol. 1996; 114:23-33. Google Scholar15. Arevalo JF, Gonzalez C, Capparelli EV, Kirsch LS, Garcia RF, Quiceno JI, et al. Intravitreous and plasma concentrations of ganciclovir and foscarnet after intravenous therapy in patients with AIDS and cytomegalovirus retinitis. J Infect Dis. 1995; 172:951-6. Google Scholar16. Martin DF, Parks DJ, Mellow SD, Ferris FL, Walton RC, Remaley NA, et al. Treatment of cytomegalovirus retinitis with an intraocular sustained-release ganciclovir implant. A randomized, controlled clinical trial. Arch Ophthalmol. 1994; 112:1531-9. Google Scholar17. Pepose JS, Holland GN, Nestor MS, Cochran AJ, Foos RY. Acquired immune deficiency syndrome. Pathogenic mechanisms of ocular disease. Ophthalmology. 1985; 92:472-84. Google Scholar18. Kirsch LS, Arevalo JF, De Clercq E, Chavez de la Paz E, Munguia D, Garcia R, et al. Phase I/II study of intravitreal cidofovir for the treatment of cytomegalovirus retinitis in patients with the acquired immunodeficiency syndrome. Am J Ophthalmol. 1995; 119:466-76. Google Scholar19. Kirsch LS, Arevalo JF, Chavez de la Paz E, Munguia D, De Clercq E, et al. Intravitreal cidofovir (HPMPC) treatment of cytomegalovirus retinitis in patients with the acquired immunodeficiency syndrome. Ophthalmology. 1995; 102:533-43. Google Scholar20. Rahhal FM, Arevalo JF, Chavez de la Paz E, Munguia D, Azen SP, Freeman WR. Treatment of cytomegalovirus retinitis with intravitreous cidofovir in patients with AIDS. Ann Intern Med. 1996; 125:98-103. Google Scholar Author, Article, and Disclosure InformationAuthors: Douglas A. Jabs, MDAffiliations: Wilmer Eye Institute, Baltimore, MD 21205Corresponding Author: Douglas A. Jabs, MD, Wilmer Eye Institute, 550 North Broadway, Suite 700, Baltimore, MD 21205. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTreatment of Cytomegalovirus Retinitis with Intravitreous Cidofovir in Patients with AIDS: A Preliminary Report Firas M. Rahhal , J. Fernando Arevalo , Eugenio Chavez de la Paz , David Munguia , Stanley P. Azen , and William R. Freeman Advances in the Management of AIDS-Related Cytomegalovirus Retinitis Henry Masur , Scott M. Whitcup , Charles Cartwright , Michael Polis , and Robert Nussenblatt Metrics Cited byTreatment of cytomegalovirus retinitis with oral valganciclovir in an acquired immunodeficiency syndrome patient unresponsive to combination antiretroviral therapy 15 July 1996Volume 125, Issue 2Page: 144-145KeywordsAIDSCytomegalovirus infectionDrug regulationDrug therapyDrugsFood and Drug AdministrationRetinaRetinitisSystemic diseasesViral replication ePublished: 15 August 2000 Issue Published: 15 July 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...