Ganciclovir intraocular

Ganciclovir intraocular implant plus valganddovir 900 mg once daily until immune recovery from ART (Al)° Ganciclovir 5 mg/kg IV every 12 hours or foscarnet 180 mg/kg/day in two or three divided doses IV for 21 to 28 days (Bll)... 

Figure 3-19 Cross-section of ganciclovir implant. (Modified from Charles NC, Steiner GC. Ganciclovir intraocular implant. A cHnicopathologic study. Ophthalmology 1996 103 416-421.)...

Ganciclovir may be administered intravenously, orally, or via intraocular implant. The bioavailability of oral ganciclovir is poor. Cerebrospinal fluid concentrations are approximately 50% of those in serum. The elimination half-life is 4 hours, and the intracellular half-life is prolonged at 16-24 hours. Clearance of the drug is linearly related to creatinine clearance. Ganciclovir is readily cleared by hemodialysis. 

Intraocular implant (Vitrasert) 4.5 mg ganciclovir/implant Idoxuridine (Herplex)... 

Chapon, P., et al. 1999. Intraocular tissues pharmacokinetics of ganciclovir transscleral coulomb controlled iontophoresis in rabbits. Invest Ophthalmol Vis Sci 40 S189. 

Ganciclovir may be administered intravenously, orally, or via intraocular implant. 

Kunou N.-O.Y., Hashizoe, M., Honda, Y., Hyon, S.H. and Ikada, Y. (1995) Controlled intraocular delivery of ganciclovir with use of biodegradable scleral implant in rabbits. Journal of Controlled Release, 37 143-150. 

In a rare cytomegalovirus comparison trial, a ganciclovir insert (an intraocular implant) plus oral ganciclovir was compared with intravenous cidofovir (18). Based on data from 61 patients (the trial was stopped early owing to low recruitment), cidofovir was associated with a raised serum creatinine concentration of 142 pmol/l (1.6 mg/dl) or greater (0.48 per person-year), 3+ or greater proteinuria (0.29 per person-year), uveitis (0.35 per person-year), and neutropenia (0.11 per person-year). 

Hodge WG, Lalonde RG, Sampalis J, Deschenes J. Once weekly intraocular injections of ganciclovir for maintenance therapy of cytomegalovirus retinitis clinical and ocular outcome. J Infect Dis 1996 174 393-396. 

Martin DF, Parks DJ, Mellow SD, et al. Treatment of cytomegalovirus retinitis with an intraocular sustained-release ganciclovir implant. A randomized controlled clinical trial. Arch Ophthalmol 1994 112 1531-1539. 

Anand R, Nightingale SD, Fish RH, Smith TJ, Ashton P. Control of cytomegalovirus retinitis using sustained release of intraocular ganciclovir. Arch Ophthalmol 1993 111 223-227. 

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