A Randomized, Controlled Study of Intravenous Ganciclovir Therapy for Peripheral Cytomegalovirus Retinitis in Patients With AIDS

Inclusion Criteria Concurrent Medication: Allowed: * Zidovudine (AZT) for patients in delayed treatment group and not receiving ganciclovir. * Didanosine (ddI) may be continued or initiated in any patient during the study. * Topical acyclovir. * Topical ophthalmics. * Aerosolized pentamidine. Patients must have: * AIDS as defined by the CDC criteria or have had confirmation of HIV infection by ELISA, p24 antigen assay, or culture of HIV. * Retinal lesions greater than 1500 microns from edge of optic disc outside major temporal vascular arcades, and greater than 3000 microns from fovea. * Understanding of study provisions, and willingness to sign informed consent form approved by the appropriate Institutional Review Board and Syntex. * Life expectancy of at least 4 months. Exclusion Criteria Co-existing Condition: Patients with ocular conditions requiring immediate surgical correction are excluded. Concurrent Medication: Excluded during first 4 weeks of ganciclovir treatment: Zidovudine (AZT). Excluded: Other investigational drugs and antimetabolites, alkylating agents, nucleoside analogs (topical ophthalmics are permitted), acyclovir, interferon, foscarnet (non-nucleoside pyrophosphate analog), cytomegalovirus (CMV) hyperimmune globulin, and cytokines. Patients with the following are excluded: * Immediately sight-threatening retinitis (= or \< 1500 microns from edge of optic disc, or inside major temporal vascular arcades, or = or \< 3000 microns from the fovea). * Ocular media opacities (corneal, lenticular, or vitreal) preventing ophthalmologic and photographic retinal assessment. * Demonstrated hypersensitivity to acyclovir. Prior Medication: Excluded: \- Previous treatment with anti-cytomegalovirus therapy.