Intravitreal foscarnet for cytomegalovirus retinitis in patients with AIDS.

To determine the visual outcome, progression, and complications of patients with acquired immuno-deficiency syndrome-related cytomegalovirus (CMV) retinitis treated with intravitrealfoscarnet (2.4 mg in 0.1 ml per injection), a retrospective study was carried out in 193 patients. Induction therapy consisted of two injections a week until the lesions were inactive. Maintenance therapy consisted of one injection a week until relapse, then re-induction was instituted. In 301 treated eyes, visual acuity remained stable in 184 (61%), improved in 16 (5%), and decreased in 101 (34%). Of these, 15 retinal detachments, 13 intravitreal hemorrhages, 3 endophthalmitis, and 2 cataract occurred. Median time of first progression was 15 weeks. Involvement of the fellow eye occurred in 35% of the patients during treatment of the first eye. Intravitreal foscarnet appeared to be a useful alternative treatment for patients intolerant or unaffordable to intravenous anti-CMV drugs, but the complications of this treatment should also be considered.

Clinical indications for penetrating keratoplasty in Maharaj Nakorn Chiang Mai Hospital, 1996-1999.

PURPOSE: To determine the leading indication for penetrating keratoplasty. MATERIAL AND METHOD: The authors retrospectively performed a chart review of the hospital records of all patients who underwent penetrating keratoplasty at Maharaj Nakorn Chiang Mai Hospital between January 1996 and December 1999. RESULTS: A total of 45 corneal transplants were performed. The leading indications for penetrating keratoplasty, in order of decreasing frequency, were bullous keratopathy (28.9%), corneal scar (22.2%), corneal dystrophy and degeneration (20.0%), corneal ulcer (17.8%), regraft (8.9%), and trauma (2.2%). CONCLUSION: Bullous keratopathy was the leading indication for penetrating keratoplasty at Maharaj Nakorn Chiang Mai Hospital from 1996 to 1999, followed by corneal scar. The major cause of bullous keratopathy was associated with posterior chamber intraocular lens implantation.