Advances in intravitreal ganciclovir treatment of cytomegalovirus retinitis after hematopoietic stem cell transplantation

Hematopoietic stem cell transplantation (HSCT) brings the possibility to prolong survival for patients with different types of hematological diseases, but patients may be complicated with cytomegalovirus retinitis (CMVR) due to immunocompromised state.Intravitreous injection of ganciclovir (IVG) is a major treatment in CMVR after HSCT, but there are significant differences in the dosage and frequency among existing IVG protocols due to lack of standardized consensus or guidelines.High-dose IVG therapy and a follow-up plan based on aqueous humor virus load and cytokine monitoring have been applied in clinical practice, and it has been reported to shorten treatment duration and reduce number of injections.Reports of retinal toxicity caused by IVG are rare, and more exploration is needed to determine the safe dose range of IVG.This article reviewed the advances in IVG treatment of CMVR after HSCT focusing on the acting mechanism of ganciclovir, the problems in systematic application, the treatment plan involving intravitreal injection, and the retinal toxicity of intravitreal injection.

Hematopoietic stem cell transplantation; Cytomegalovirus retinitis; Ganciclovir; Intravitreal injections; Clinical protocols