Two Cases of Intravitreal Ganciclovir Injection for Cytomegalovirus Retinitis

Jung Bin Han; Seung Won Lee; Hyung Woo Kwak

doi:10.3341/jkos.2013.54.6.977

Journal List > J Korean Ophthalmol Soc > v.54(6) > 1009716

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Han, Lee, and Kwak: Two Cases of Intravitreal Ganciclovir Injection for Cytomegalovirus Retinitis

Original Article

J Korean Ophthalmol Soc 2013;54(6):977-981.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.6.977

Two Cases of Intravitreal Ganciclovir Injection for Cytomegalovirus Retinitis

Jung Bin Han, MD, Seung Won Lee, MD, Hyung Woo Kwak, MD, PhD

Department of Ophthalmology, KyungHee University Medical Center, KyungHee University School of Medicine, Seoul, Korea

Address reprint requests to Hyung Woo Kwak, MD, PhD Department of Ophthalmology, KyungHee University Medical Center #23 Gyeonghui-daero, Dongdaemun-gu, Seoul 130-872, Korea Tel: 82-2-958-8451, Fax: 82-2-966-7340, E-mail: hwkwak@khu.ac.kr

Received 21 December 201210 January 2013 Accepted 22 April 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report 2 cases of cytomegalovirus retinitis treated with intravitreal ganciclovir.

Case summary

A 29-year-old female (Case 1) who received immunosuppressive therapy with tacrolimus and mycophe-nolate mofetil for 3 months after pancreatic transplantation, was given an intravitreal Bevacizumab injection 4 times in each eye under the suspicion of bilateral central retinal vein occlusion. During follow-up, a new lesion with white opacification and multiple snowballs appeared in the left eye. Suspecting cytomegalovirus retinitis, we administered an intravitreal ganciclovir injection resulting in a decrease of white opacification and improvement of visual acuity. A 66-year-old male (Case 2) who was receiving treatment for general weakness and heart failure, presented with visual disturbance in both eyes. Fundoscopic examination revealed white opacification, multiple snowballs and retinal hemorrhage in the left eye; di-agnostic vitrectomy was performed. Macular edema and subretinal fluid continued after the vitrectomy and the serologic testing revealed an IgG titer positive for cytomegalovirus, therefore, an intravitreal injection of ganciclovir was given. Macular edema and subretinal fluid decreased and visual acuity improved.

Conclusions

Intravitreal ganciclovir can be an effective treatment option for the management of CMV retinitis. J Korean Ophthalmol Soc 2013;54(6):977-981

Keywords: Cytomegalovirus retinitis, Ganciclovir, Intravitreal ganciclovir injection

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Figure 1.

Fundus photographs & OCT of both eyes in case 1. (A) Fundus photograph of the left eye shows opaque white lesions at the inferonasal retina. (B) Fundus photograph of the left eye shows disappearance of opaque white lesions. (C) OCT of left eye shows residual macular edema. (D) OCT of left eye shows residual macular edema.

Figure 2.

Fundus photographs & OCT of both eyes in case 2. (A) Fundus photograph of right eye shows retinal hemorrhage with opaque white lesions in inferior region of the optic disc and atrophic lesions at the temporal region. (B) Fundus photo-graph of the right eye shows improvement of retinal hemorrhage with opaque white lesions. (C) OCT of the right eye shows macular edema and submacular fluid. (D) OCT of the right eye shows no macular edema and submacular fluid.

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