Low dose intravitreal HPMPC (CIDOFOVIR) therapy for CMV retinitis in patients with aids

I. Taskintuna, F. M. Rahhal, J. F. Arevalo, D. Munguia, A. S. Banker, E. D. Clercq, W. R. Freeman

Research output: Contribution to journalArticle

Abstract

Purpose: We have shown that 20 μg injections of HPMPC intravitreally are highly effective in long term treatment of CMV retinitis, but iritis and pressure lowering may be a problem in some cases. We, therefore, evaluated the efficacy of 10 μg intravitreal HPMPC injections. Methods: Twenty-eight eyes of 19 patients received 10 μg HPMPC for the treatment of CMV retinitis. None of the patients received systemic treatment during the study. The primary outcome of the study was time to retinitis progression after the first injection, secondary outcomes were incidence of iritis and intraocular pressure lowering effect of HPMPC. We evaluated the time to retinitis progression after second injections in 16 eyes of 12 patients, as well. Results: The median time to retinitis progression was 45 days (mean, 45.6± 4.4 days) after first injections this was lower than our series injected with 20 μg (p<0.03,Log-Rank test) and appeared due to a 25% incidence of primary failure (progression ≥ 750 μm within 28 days, p<0.002 Wilcoxon test).The median time to retinitis progression after second injections was 32 days (mean, 29.7±4.1 days), this was lower than the first injections (p<0.01, Log-Rank test). There was no iritis in 18 eyes after first injections. This was lower than with 20 μg injections (p<0.03). Out of 45 total injections there was only one episode of iritis, this was statistically lower than our series with 20 μg injections (p<0.003, Chi square). The IOP drop between baseline and 2 weeks was small (0.9 mmHg, p=0.07), and there was no drop or trend at 5 weeks (p=0.66). Conclusions: Treatment of CMV retinitis with 10 μg of intravitreal cidofovir was not as effective as with 20 μg, but there were fewer side effects with this dose. New studies for the most efficient dose must be carried out.

Original languageEnglish (US)
Pages (from-to)S669
JournalInvestigative Ophthalmology and Visual Science
Volume37
Issue number3
StatePublished - Feb 15 1996

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ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Taskintuna, I., Rahhal, F. M., Arevalo, J. F., Munguia, D., Banker, A. S., Clercq, E. D., & Freeman, W. R. (1996). Low dose intravitreal HPMPC (CIDOFOVIR) therapy for CMV retinitis in patients with aids. Investigative Ophthalmology and Visual Science, 37(3), S669.