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B. Kauffman, R. Rescigno, M.A. Zarbin, N. Bhagat; High–Dose Intravitreal Ganciclovir and Foscarnet for the Treatment of Acute Retinal Necrosis and Progressive Outer Retinal Necrosis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3049.
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To evaluate the efficacy and safety of high–dose intravitreal injections of foscarnet and ganciclovir for the treatment of acute retinal necrosis (ARN) and progressive outer retinal necrosis (PRN).
A retrospective review was conducted to identify eyes diagnosed with ARN or PRN that underwent treatment with high dose intravitreal foscarnet (2.4 mg) and ganciclovir (2.0 mg) injections between 1997 and 2004. Data collected from patient charts was analyzed to determine the efficacy and safety of the intravitreal treatment procedure. Measured outcomes included best–corrected visual acuity, fundus photography documenting resolution of active retinitis, and secondary complications including retinal detachment.
Eight eyes were identified in the time period 1997 – 2004 who underwent high dose intravitreal injections of foscarnet and ganciclovir for ARN or PRN. PCR testing of the vitreous confirmed the clinical diagnosis of ARN or PRN in each case. Initial visual acuity at presentation ranged from 20/25 to 20/400. Final visual acuity ranged from 20/25 to NLP. Retinal detachment was present in 1 eye at presentation and developed later in 2 other eyes. Significant and early resolution of disease was seen in most cases. No retinal toxicity was observed in any of the eyes in the series.
Intravitreal injections of high–dose foscarnet (2.4 mg) and Ganciclovir (2.0 mg) offer a safe and efficacious treatment for ARN and PRN. In addition to serving as an excellent adjunctive therapy to the traditional intravenous or oral medications, the intravitreal injections alone can be a successful alternative treatment in those unwilling or unable to tolerate systemic therapy.
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