Douglas J. Rhee, MD

Intravitreal (high dose) 2000 µg in 0.1 ml(induction) 2×/wk for 3 weeks, then2000 µg in 0.1 ml Qwk (maintenance) 4PO maintenance 1000–1500 mg TID with Oral ganciclovir in conjunction with a ganciclovir implantfood reduces the incidence of CMV retinitis 5Vitrasert Sustained release intraocular implant4.5 mg (1 µg/hr) 6Continue therapy for 32 weeks or untilprogression of disease despite implantvalacyclovir Valtrex 1.0 gm PO TID × 7–14 days For VZV ophthalmicus (within 72 hours of rash onset),3–5× more bioavailable than acyclovir, not advised inimmunocompromised patients due to thrombocytopenicpurpura; must adjust dose in renal failure 1500 mg PO BID or 1 gm PO QD For prevention of recurrent HSV keratitisindefinitely1 For renal dosing, see Appendix 4.2 For acute retinal necrosis, consider addition of systemic steroids and possibly anticoagulation (controversial).3 Probenicid should be given 2 gm PO 3 hr prior to cidofovir infusion and 1 gm at 2 and 8 hr post infusion.4 From Ophthalmology 1998;105:1404–10.5 From N Engl J Med 1999;340:1063–1070.6 From Arch Ophthalmol 1994; 112:1512–1539.Antiviral Agents 45