To report the use of intravitreal antiviral injections as adjunctive therapy in the managementof two immunocompetent patients with acute retinal necrosis.

We performed two or three intravitreal injections of gancyclovir (2,000 µg/0.05 ml) on two patients (two eyes) with acute retinal necrosis resistant to intravenous acyclovir therapy (1,500 mg/m²/day). Both patients received intravitreal antiviral injections for the treatment of retinitis that progressed despite standard intravenous acyclovir therapy. The retinitis resolved, and visual acuity improved after 18 months of follow-up in both cases.

Intravitreal antiviral injections may be a safe and efficacious adjunctive therapy in the management of patients with acute retinal necrosis resistant to intravenous acyclovir therapy.