Clinico-histopathologic correlation of ganciclovir-treated cytomegalovirus retinitis

A 46 year old AIDS-patient, who had developed CMV-retinitis was treated with the virostatic drug dihydroxypropoxymethylguanine (DHPG, Ganciclovir) over a period of 16 months until he died due to a pneumonia. After the DHPG-treatment was initiated the retinitis improved markedly, however there still was a very slow progression of the disease in the following time. The central retina of both eyes was not affected until death. Postmortal immunohistochemically CMV-antigen-staining was positive according to the former clinically active retinitis. At the eyes of the retinal necrosis calcified deposits were identified by Kossa-staining; these areas had clinically appeared as yellowish briddle deposits. The clinical course and the immunohistochemical proof of active CMV-virus-particles suggest that DHPG was able to suppress the progression of a CMV-retinitis and to preserve a good visual acuity until death; however a true cure of the CMV-infection could not be achieved.