A Randomized, Controlled Study of Intravenous Ganciclovir Therapy for Peripheral Cytomegalovirus Retinitis in Patients With AIDS

Inclusion Criteria Concurrent Medication: Allowed: Zidovudine (AZT) for patients in delayed treatment group and not receiving ganciclovir. Didanosine (ddI) may be continued or initiated in any patient during the study. Topical acyclovir. Topical ophthalmics. Aerosolized pentamidine. Patients must have: AIDS as defined by the CDC criteria or have had confirmation of HIV infection by ELISA, p24 antigen assay, or culture of HIV. Retinal lesions greater than 1500 microns from edge of optic disc outside major temporal vascular arcades, and greater than 3000 microns from fovea. Understanding of study provisions, and willingness to sign informed consent form approved by the appropriate Institutional Review Board and Syntex. Life expectancy of at least 4 months. Exclusion Criteria Co-existing Condition: Patients with ocular conditions requiring immediate surgical correction are excluded. Concurrent Medication: Excluded during first 4 weeks of ganciclovir treatment: Zidovudine (AZT). Excluded: Other investigational drugs and antimetabolites, alkylating agents, nucleoside analogs (topical ophthalmics are permitted), acyclovir, interferon, foscarnet (non-nucleoside pyrophosphate analog), cytomegalovirus (CMV) hyperimmune globulin, and cytokines. Patients with the following are excluded: Immediately sight-threatening retinitis (= or < 1500 microns from edge of optic disc, or inside major temporal vascular arcades, or = or < 3000 microns from the fovea). Ocular media opacities (corneal, lenticular, or vitreal) preventing ophthalmologic and photographic retinal assessment. Demonstrated hypersensitivity to acyclovir. Prior Medication: Excluded: - Previous treatment with anti-cytomegalovirus therapy.