Efficacy of ganciclovir versus foscarnet in ganciclovir-resistant cytomegalovirus retinitis: A case report

Eur J Ophthalmol. 2023 Sep;33(5):NP105-NP108. doi: 10.1177/11206721221136316. Epub 2022 Oct 30.

Abstract

Purpose: To report a case of cytomegalovirus (CMV) retinitis improved by treatment with ganciclovir in a patient with ganciclovir-resistant CMV infection associated with Good syndrome.

Study design: Case report.

Result: A 52-year-old gentleman with Good syndrome presented with visual disturbance in his right eye. He had a history of receiving intravitreal ganciclovir treatment with CMV retinitis a year ago. During treatment for CMV colitis three months ago, in systemic blood, UL97 mutation was identified and improved after changing treatment from ganciclovir to foscarnet. CMV retinitis recurred, and intravitreal ganciclovir injection was performed but there was no improvement. Therefore, the treatment was changed to foscarnet, but retinal infiltration progressed. Accordingly, it was changed to ganciclovir again and as a result, the progression of retinitis could be stopped.

Conclusions: Even in the case of CMV retinitis, which has been genetically confirmed to be ganciclovir resistance in systemic blood, ganciclovir treatment can be considered if other anti-CMV agents are not effective.

Keywords: Retina - medical therapies; cytomegalovirus retinitis; ganciclovir; good syndrome; retinal herpetic infections.

Publication types

  • Case Reports

MeSH terms

  • Antiviral Agents* / therapeutic use
  • Cytomegalovirus Retinitis* / diagnosis
  • Cytomegalovirus Retinitis* / drug therapy
  • Foscarnet* / therapeutic use
  • Ganciclovir* / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Treatment Outcome

Substances

  • Ganciclovir
  • Antiviral Agents
  • Foscarnet