Pigmentary Retinopathy Associated with Intravitreal Fomivirsen

Abstract

Abstract: : Purpose: This study reports retinal and electroretinographic changes in eyes receiving intravitreal fomivirsen for cytomegalovirus retinitis. Methods: We observed two eyes with retinal pigmentary and electroretinographic abnormalities after intravitreal fomivirsen. We also reviewed records of all patients who received intravitreal fomivirsen. Results: Thirty-four injections were administered in ten eyes of nine patients (range: 1 to 23 injections per eye). Two eyes of two patients who failed highly active antiretroviral therapy developed retinal pigment changes in the mid peripheral retina associated with absent rod response and 40-50% reduction in cone amplitude. The first patient received only 1 injection. The second patient received a total of 5 injections. Conclusion: Eyes treated with approved dosage regimen of intravitreal fomivirsen developed retinal toxicity. This study’s findings support the premise that intravitreal fomivirsen may have a narrow therapeutic index.

Keywords: 382 cytomegalovirus • 390 drug toxicity/drug effects • 353 clinical (human) or epidemiologic studies: outcomes/complications