Cytomegalovirus retinitis and AIDS in Edinburgh.
The medical records, retinal drawings and fundus photographs of all patients with cytomegalovirus retinitis (CMVR) and AIDS in Edinburgh between 1986-1992 were reviewed to determine the efficacy of treatment in preserving vision. Ophthalmoscopic features of CMVR were observed in 32 eyes of 24 patients with AIDS, 19 males and 5 females. HIV transmission in this group was by homo/bisexual contact (16), injection drug use (7) and blood transfusion (1). Unilateral blurring was the commonest visual symptom although 9 (38%) patients had no visual symptoms. All patients presented with a corrected visual acuity of 6/12 or better in at least one eye. Following treatment with systemic ganciclovir or foscarnet 16 patients (66%) developed toxic side-effects of therapy and 13 (54%) experienced a recurrence of CMVR. Four (17%) patients developed a retinal detachment in one eye. The mean survival was 8.3 months after the diagnosis of CMVR. At final follow-up, between 2-26 months after the diagnosis of CMVR, 21 (87.5%) patients retained useful vision (6/18 or better) although 3 (12.5%) were effectively blind (less than 6/60). We conclude that with prompt diagnosis and treatment of CMVR vision can be preserved in the majority of cases.
Dhillon
B
B
Princess Alexandra Eye Pavilion, Edinburgh, UK.
Maclean
H
H
Eddyshaw
D
D
Cheong
I
I
Flegg
P
P
Brettle
R
R
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D000328:Adult; D017726:Cytomegalovirus Retinitis / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D017245:Foscarnet / Q000009:adverse effects / Q000627:therapeutic use*; D015774:Ganciclovir / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D012008:Recurrence; D012606:Scotland / Q000453:epidemiology; D016896:Treatment Outcome
D017245:Foscarnet; D015774:Ganciclovir