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Intravitreal injections of antivirals, antifungals and antibiotics are very efficacious in the management of intraocular infections, which is not the case with per os, intravenous or peribulbar administration. However, these drugs have some toxic potential, more pronounced if used in intraocular condition. Being too toxic, aminoglycosides have been replaced by Ceftazidime and Vancomycine in the management of bacterial endophthalmitis. Efficacy of these drugs for prophylactic use is not demonstrated and their toxic potential remains to be kept in mind.

Purpose: To assess the efficacy and tolerability of high-dose (2000microg) intravitreous ganciclovir in the maintenance therapy of CMV retinitis in AIDS patients., Material: and methods: Prospective open study in a single center. The maintenance therapy of CMV retinitis consisted of a single high-dose (2000microg) intravitreous injection per week. The evaluation criteria were clinical examinations, and photographs when necessary., Results: Over a 44-week period, twenty-four eyes (15 patients) have been included. The relapse rate evaluated by the survival curves method was 5% at 44 weeks. No ocular toxicity was reported after a follow-up of 24 weeks., Conclusion: High-dose intravitreous ganciclovir induces a prolonged remission of CMV retinitis and is well tolerated. Therefore, we recommend the use of the 2000microg dosage per intravitreous injection instead of the classical dosage of 400microg.