Systemic ganciclovir treatment, however, was declined by the infectious disease consultants owing to risk of neutropenia. On DOL 4, intravitreous ganciclovir sodium (600 μg in 0.03-mL volume) was administered to each eye. Rapid and dramatic improvement of retinitis and optic neuritis was observed 3 days later. During the next 2 weeks, 2 additional injections were given in the right eye and 1 was given in the left eye. On DOL 25 (2 weeks following the last injection), retinitis recurred in both eyes. Systemic ganciclovir treatment was again recommended in the setting of recurrent CMV ocular infection and underlying central nervous system disease but was declined again by the infectious disease consultants. During the next 3 weeks, 3 and 4 more injections of intravitreous ganciclovir were given in the right and left eyes, respectively. By DOL 65, a total of 12 injections (6 per eye) had been administered (Figure 2). No ocular complications (cataract, retinal whitening, or inflammation) or systemic complications (neutropenia) were observed after any intravitreous ganciclovir treatment. At the most recent examination (on DOL 95), there was no sign of active disease in either eye.