title: [Indications for eye examination of HIV patients--screening parameters for cytomegalovirus retinitis].
abstract: BACKGROUND
  To reduce the burden of frequent visits at the physician we have checked (I) for which ocular manifestations in HIV-infection screening of asymptomatic patients is worthwhile and (II) which parameters may indicate patients at risk for CMV-retinitis.
  
  
  METHODS
  The clinical data of 215 HIV-infected patients were analyzed retrospectively. Only those ocular manifestations were considered suitable for screening that (a) endanger vision, (b) are treatable, (c) can be diagnosed sufficiently early and (d) are common. Furthermore (1) CDC-stage, (2) CD4+ count, (3) HIV-retinopathy, (4) CMV-uria and (5) CMV-antibodies were checked for their usefulness in indicating patients at risk for CMV-retinitis.
  
  
  RESULTS
  Ophthalmological screening of asymptomatic HIV-patients should focus on cytomegalovirus (CMV)-retinitis because early diagnosis of this common blinding disease improves the visual outcome. 85 of 215 HIV-infected patients had a CD4+ count less than 50 cells/microliters 25% of these patients developed CMV-retinitis (21/85). The risk for CMV-retinitis rose to 38% (13/34) when the low CD4+ count was accompanied by CMV-uria. The proportion of patients with CMV-retinitis did not increase when HIV-retinopathy had been diagnosed earlier (12/48 = 25%). CMV-serology and CDC-classification were not helpful in screening for CMV-retinitis.
  
  
  CONCLUSIONS
  We recommend the following ophthalmological screening scheme for HIV-patients without ocular symptoms: (1) patients with a CD4+ count < 100 cells/microliters should be checked every third month and (2) those with a CD4+ count < 50 cells/microliters and CMV-uria every sixth week.
authors.affiliation: Universitäts-Augenklinik Freiburg.
authors.forename: M M
authors.initials: MM
authors.lastname: Gellrich
authors.forename: W D
authors.initials: WD
authors.lastname: Lagrèze
authors.forename: J A
authors.initials: JA
authors.lastname: Rump
authors.forename: L L
authors.initials: LL
authors.lastname: Hansen
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D018791:CD4 Lymphocyte Count; D017726:Cytomegalovirus Retinitis / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005858:Germany; D006679:HIV Seropositivity / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012307:Risk Factors