Department of Ophthalmology, New York Presbyterian Hospital-Cornell Medical Center, New York, NY, USA.
For many years the clinician's arsenal for managing cytomegalovirus (CMV) retinitis included only systematic therapies that required daily infusions via a central venous catheter. The introduction of cidofovir has permitted biweekly maintenance therapy by peripheral IV. Local therapies, such as the ganciclovir intraocular device and intravitreal injections of cidofovir, fomavirsen, or ganciclovir, have reduced toxicity while increasing absorption of drug in the eye. At the same time, due to highly active antiretroviral therapy (HAART), the incidence of CMV retinitis is dropping. Current investigation into the natural history of CMV retinitis in the era of HAART may ultimately result in new management strategies.