Intravitreal sustained-release ganciclovir implants for severe bilateral cytomegalovirus retinitis after stem cell transplantation

Acta Ophthalmologica Scandinavica
Fredrik GhoshAlbert N Békássy

Abstract

To describe the treatment of cytomegalovirus (CMV) retinitis with intravitreal sustain-release ganciclovir devices in a 16-year-old patient in third remission of acute lymphoblastic leukemia after stem cell transplantation. The patient received a stem cell transplant from an unrelated bone marrow donor after which he contracted a serious CMV infection manifested in the lungs and retinae. His immune system at this time was almost completely depleted. Implantation of a sustained-release ganciclovir device was performed in both eyes when retinitis progressed in spite of aggressive antiviral intravenous treatment. No per- or postoperative complications were noted. Infiltrates, hemorrhages and macular edema present preoperatively dissolved over a period of six months. The final visual acuity was 1.0 in both eyes. The patients immune system and lung function slowly recovered during the same time period. The intravitreal ganciclovir implant provides safe and effective therapy against CMV retinitis, and should be considered in patients acquiring the infection after stem cell transplantation.

Citations

Oct 9, 2012·Journal of Pediatric Hematology/oncology·Ramandeep SinghSwapnil Bhalekar
Apr 1, 2005·Acta Ophthalmologica Scandinavica·Eckart BertelmannChristian Hartmann
Jun 27, 2006·Transplantation Proceedings·Y A AkovaM Haberal
Sep 18, 2013·Cancer Letters·Ella J Ariza-HerediaRoy F Chemaly
Aug 28, 2014·Case Reports in Ophthalmological Medicine·Hande CelikerAhmet Koc
Apr 12, 2019·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Stefan K ZöllnerAndreas H Groll
Sep 8, 2011·International Ophthalmology Clinics·Anthony B DanielsLucy H Y Young

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