11.4 Retinitis
| Type of Infection | First Line (with Dosage and Duration) |
Alternative First Line (with dosage and Duration) |
Comments |
|---|---|---|---|
| CMV | Induction: intravenous Ganciclovir 5 mg/kg every 12 hours for 14 to 21 days & Maintenance phase 5 mg/kg/d Or Valganciclovir induction therapy consists of 900 mg BD, followed by 900 mg/d for maintenance. | Intravitreal injection of Ganciclovir 2.5 mg/0.05 ml weekly for 2 to 3 weeks Or Foscarnet 2.4 mg/injection administered twice weekly for 2 to 4 doses with concurrent systemic therapy | In all cases of infective retinitis, the antimicrobial should be initiated first, followed by steroids. Initiating steroids in the presence of infective retinitis or panuveitis without antimicrobial coverage may result in severe ocular damage and could be life-threatening if systemic disease is present. |
| Acute retinal necrosis |
For common etiological agents of Retinitis, see Annexure B.11.4
Additional Information
- Patients presenting with posterior uveitis and no evidence of an underlying etiology should undergo a chest radiograph to evaluate for pulmonary sarcoidosis or infections such as tuberculosis. In addition, affected patients should undergo serology to rule out syphilis.