Clinical outcomes in patients with cytomegalovirus retinitis treated with ganciclovir implant.
Publication/Presentation Date
4-1-2012
Abstract
PURPOSE: To describe the clinical outcomes of patients with cytomegalovirus (CMV) retinitis and AIDS treated with ganciclovir implant.
DESIGN: Retrospective cohort study.
METHODS: The charts of 115 patients (166 affected eyes) with CMV retinitis treated with ganciclovir implant in the Division of Ocular Immunology, Wilmer Eye Institute from April 1996 through November 2009 were reviewed. Ophthalmologic data collected included visual acuity, ocular complications, treatment, and presence of immune recovery. Kaplan-Meier analyses and Cox regression models were used to investigate relationships between potential risk factors and ocular outcomes.
RESULTS: At implantation, 55% of patients were prescribed highly active antiretroviral therapy (HAART), 21% were formerly on HAART, and 24% were HAART-naïve. One hundred sixty-six eyes received 257 ganciclovir implants. Fifty-seven of the implanted eyes were diagnosed with a total of 126 ocular complications after implant surgery (rate=0.19/eye-year [EY]), the 3 most common being cataract, vitreous hemorrhage, and retinal detachment. Despite these ocular complications, the development of severe vision loss (≥6 lines lost) was low (0.005/EY). Patients with immune recovery during follow-up were less likely to have ocular complications after implant surgery; however, only the risk reduction for retinal detachment achieved statistical significance (hazard ratio=0.29, 95% CI: 0.08, 0.98).
CONCLUSIONS: Our data suggest that ocular complications after implant surgery, including cataract, vitreous hemorrhage, and retinal detachment, were relatively common after ganciclovir implantation but severe vision loss after surgery was low. Presence of immune recovery may lessen the risk of postoperative ocular complications.
Volume
153
Issue
4
First Page
728
Last Page
733
ISSN
1879-1891
Published In/Presented At
Oktavec, K. C., Nolan, K., Brown, D. M., Dunn, J. P., Livingston, A. G., & Thorne, J. E. (2012). Clinical outcomes in patients with cytomegalovirus retinitis treated with ganciclovir implant. American journal of ophthalmology, 153(4), 728–733.e7332. https://doi.org/10.1016/j.ajo.2011.09.010
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
22265144
Department(s)
Administration and Leadership
Document Type
Article