       Document 0505
 DOCN  M9460505
 TI    High dose intravitreal foscarnet in the treatment of cytomegalovirus
       retinitis in AIDS.
 DT    9404
 AU    Diaz-Llopis M; Espana E; Munoz G; Navea A; Chipont E; Cano J; Menezo JL;
       Romero FJ; Department of Ophthalmology, La Fe University Hospital,
       Valencia,; Spain.
 SO    Br J Ophthalmol. 1994 Feb;78(2):120-4. Unique Identifier : AIDSLINE
       MED/94169109
 AB    The efficacy and tolerance of high dose intravitreal foscarnet for
       cytomegalovirus retinitis in patients with AIDS was studied. Foscarnet
       in a dose of 2400 micrograms was injected directly into the vitreous of
       11 patients (15 eyes). Five patients had active retinitis (eight eyes,
       53.3%), and received a 3 week induction therapy of six injections as the
       first step. Six patients had initial inactive retinitis (seven eyes,
       46.7%), and received only maintenance therapy which consisted of a
       weekly injection. The main indications for intravitreal therapy were:
       myelosuppression, kidney toxicity, catheter related sepsis, or refusal
       of intravenous therapy. The patients were followed for a mean period of
       16 weeks (range 8-28 weeks) and received a total of 304 injections.
       Vitreous foscarnet levels were measured by high performance liquid
       chromatography. After a 3 week course of induction therapy, complete
       resolution of the active retinitis was seen in 62.5% (5/8 cases), while
       37.5% (3/8 cases) had partial resolution. No cases failed to respond or
       progress. The rate of relapse on maintenance therapy was 33% (five of 15
       eyes) by 20 weeks, and two of these eyes did not respond to reinduction
       and progressed in involvement of the macula or optic nerve. Neither
       important local complications nor intraocular drug toxicity were
       observed. Vitreous foscarnet levels in two different patients were 896
       mumol/l and 74.9 mumol/l at 22 3/4 hours and 42 1/2 hours after the
       injection. Intravitreal foscarnet appears to be a safe, effective, and
       useful alternative in patients with intolerance to intravenous and viral
       therapy.
 DE    Adult  AIDS-Related Opportunistic Infections/COMPLICATIONS/*DRUG THERAPY
       Cytomegalovirus Retinitis/COMPLICATIONS/*DRUG THERAPY  Female
       Foscarnet/*ADMINISTRATION & DOSAGE  Human  Injections  Male  Prospective
       Studies  Recurrence  Support, Non-U.S. Gov't  Treatment Outcome  Visual
       Acuity  CLINICAL TRIAL  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

