TY - JOUR
T1 - Visual acuity outcomes in cytomegalovirus retinitis
T2 - Early versus late diagnosis
AU - Ausayakhun, Somsanguan
AU - Yen, Michael
AU - Jirawison, Choeng
AU - Ausayakhun, Sakarin
AU - Khunsongkiet, Preeyanuch
AU - Leenasirimakul, Prattana
AU - Kamphaengkham, Siripim
AU - Snyder, Blake M.
AU - Heiden, David
AU - Holland, Gary N.
AU - Margolis, Todd P.
AU - Keenan, Jeremy D.
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2018/12
Y1 - 2018/12
N2 - Aims To determine if early dilated fundus examination for cytomegalovirus (CMV) retinitis leads to better visual outcomes in areas with limited HIV care, where patients may have long-standing retinitis before they are diagnosed with HIV. Methods Twenty-four eyes of 17 patients with CMV retinitis who were seen at an urban HIV clinic in Chiang Mai, Thailand, were included in this retrospective cohort study. Participants were divided into two groups based on the amount of time from the first documented CD4 count below 100 cells/mm 3 to the first eye examination for CMV retinitis. Average visual acuity in each group was calculated at the time CMV retinitis was first detected, and then at 3, 6 and 12 months after diagnosis. Results The group of patients who received an eye examination within approximately 4 months of the initial low CD4 count measurement had better baseline visual acuity (median 20/30,IQR 20/20 to 20/60) compared with patients who presented later (median 20/80, 20/60 to hand motion); p=0.03). Visual acuity did not change significantly during the 12-month study period in either the early group (p=0.69) or late group (p=0.17). Conclusion In this study, patients who were examined sooner after a low CD4 count had better vision than patients who were examined later. Routine early screening of patients with CD4 counts under below 100 cells/mm 3 may detect earlier disease and prevent vision loss.
AB - Aims To determine if early dilated fundus examination for cytomegalovirus (CMV) retinitis leads to better visual outcomes in areas with limited HIV care, where patients may have long-standing retinitis before they are diagnosed with HIV. Methods Twenty-four eyes of 17 patients with CMV retinitis who were seen at an urban HIV clinic in Chiang Mai, Thailand, were included in this retrospective cohort study. Participants were divided into two groups based on the amount of time from the first documented CD4 count below 100 cells/mm 3 to the first eye examination for CMV retinitis. Average visual acuity in each group was calculated at the time CMV retinitis was first detected, and then at 3, 6 and 12 months after diagnosis. Results The group of patients who received an eye examination within approximately 4 months of the initial low CD4 count measurement had better baseline visual acuity (median 20/30,IQR 20/20 to 20/60) compared with patients who presented later (median 20/80, 20/60 to hand motion); p=0.03). Visual acuity did not change significantly during the 12-month study period in either the early group (p=0.69) or late group (p=0.17). Conclusion In this study, patients who were examined sooner after a low CD4 count had better vision than patients who were examined later. Routine early screening of patients with CD4 counts under below 100 cells/mm 3 may detect earlier disease and prevent vision loss.
KW - infection
KW - retina
UR - http://www.scopus.com/inward/record.url?scp=85053192438&partnerID=8YFLogxK
U2 - 10.1136/bjophthalmol-2018-312191
DO - 10.1136/bjophthalmol-2018-312191
M3 - Article
C2 - 30206157
AN - SCOPUS:85053192438
SN - 0007-1161
VL - 102
SP - 1607
EP - 1610
JO - British Journal of Ophthalmology
JF - British Journal of Ophthalmology
IS - 12
ER -