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LETTER TO EDITOR |
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Year : 2002 | Volume
: 50
| Issue : 3 | Page : 249-50 |
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Effect of combination antiretroviral therapy on cytomegalovirus retinitis
Yogendra G Vabale
Correspondence Address: Yogendra G Vabale
Source of Support: None, Conflict of Interest: None | Check |
PMID: 12355709
Keywords: Antiviral Agents, therapeutic use, Cytomegalovirus Retinitis, drug therapy, Drug Therapy, Combination, Humans,
How to cite this article: Vabale YG. Effect of combination antiretroviral therapy on cytomegalovirus retinitis. Indian J Ophthalmol 2002;50:249 |
Dear Editor,
I read with interest the informative article by Alay S. Banker et al.[1] This article had mentioned two important points regarding the treatment of active cytomegalovirus (CMV) retinitis.
- 1. Immune recovery vitritis (IRV) is one of the common sequelae of active CMV retinitis undergoing combination antiretroviral therapy (41.7%).
- 2. Of these IRV patients, 80% (4 out of 5 patients with IRV) had a history of intravitreal cidofovir therapy.
I have a few important questions on these points, related to IRV. Is IRV preventable? Or can any attempt be made to decrease its severity? If Yes, then can we use intravitreal steroid (dexamethasone 200-400 μg) simultaneously with intravitreal cidoforir? (This is related to 4 out of 5 IRV patients, i.e. 80%). All patients with IRV received 1 ml of deep posterior subtenon depomedrol injection (40 mg/ml) and all responded with clearing of vitritis and improvement in visual acuity to previous levels.[2]
Can we use prophylactically subtenon depomedrol injection in all patients with CMV retinitis undergoing combination antiviral therapy; and at the same time as the onset of antiretroviral therapy?
References | | |
1. | Banker AS, Patel A.. Effect of combination antiretroviral therapy on cytomegalovirus retinitis. Indian J Ophthalmol 2002;50:29-33. [ PUBMED] |
2. | Henderson HW, Nitchell SM. Treatment of immune recovery vitritis with local steroids. Br J Ophthalmol 1999;83:540-45. |
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