Ocular Complications of HIV/AIDS in the Era of HAART

Millena G Bittencourt; Owhofasa O Agbedia; Hong T Liu; Rachel Annam; Yasir J Sepah; Henry Alexander Leder; Raafay Sophie; Mohamed Ibrahim; Abeer Akhtar; Anam Akhlaq; Diana V Do; Quan Dong Nguyen


Expert Rev Ophthalmol. 2012;7(6):555-564. 

In This Article

Five-year View

Currently, the treatment of CMVR includes systemic and local administration of antiviral therapy. Prolonged and repeated use of antiviral therapy has led to the evolution of certain strains of CMV which are resistant to ganciclovir and foscarnet. Alternatives to treatment-resistant strains are already being tested and studies in animals have shown promising results. Hexadecyloxypropyl-cyclic cidofovir, a long lasting prodrug of cidofovir, injected intravitreally, may be one of these future alternatives.[98] The drug has not been tested in humans and the toxicity profile needs further evaluation. We anticipate that new therapies and routes of drug administration will evolve and provide additional treatment options to prevent and manage some of the complications we have discussed in this article. The role of corticosteroid implant in the management of recalcitrant IRU requires extensive research. Preliminary results from case series have shown the implant to be a feasible alternative to systemic and local corticosteroid therapy. Finally, we hope that with recent advancements in the management of patients with AIDS and the emphasis on zero new infection, IRU and CMV resistant strains will be a rare complication in our clinics and those of others.