Purchase this article with an account.
J.E. Thorne, D.A. Jabs, J.H. Kempen, J.T. Holbrook, C. Nichols, C.L. Meinert, Studies of Ocular Complications of AIDS (SOCA) Research Group; Visual Acuity Loss Among Patients With AIDS and CMV Retinitis in the Era of Highly Active Antiretroviral Therapy (HAART) . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3055.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To describe the incidence of vision loss among patients with AIDS and CMV retinitis in the HAART era, and to describe the risk factors for and potential causes of such vision loss.
Three–hundred, seventy–nine patients (494 eyes) with CMV retinitis were followed every 3 months in a multicenter, prospective observational study. Incidence rates of visual acuity loss to 20/50 or worse, 20/200 or worse, and a doubling of the visual angle were calculated. Risk factors and potential causes of vision loss were assessed.
The incidence rates of vision loss to 20/50 or worse, 20/200 or worse, and a doubling of the visual angle were 10%/eye–year (EY), 6%/EY, and 13%/EY respectively. Eyes with retinal lesions greater than or equal to 25% of the total retinal area and with newly diagnosed CMV retinitis were at greater risk for vision loss than eyes with smaller retinal lesions or with longstanding CMV retinitis. Immune recovery was associated with a 42% to 61% reduction in vision loss after adjusting for confounding. Zone 1 CMV retinitis and retinal detachment accounted for approximately 50% and 15% of incident vision loss respectively. In subset analysis, cataract and cystoid macular edema (CME) were associated with vision loss in eyes of patients with longstanding CMV retinitis and immune recovery but not in eyes of patients with newly diagnosed CMV retinitis.
Cytomegalovirus retinitis continues to be associated with a substantial risk of vision loss. Patients with immune recovery have approximately a 50% lower risk of visual acuity loss. Zone 1 involvement and retinal detachment remain the most common causes of vision loss among patients with CMV retinitis. Cataract and CME also are common causes of visual acuity loss, primarily in those patients with HAART–induced immune recovery.
This PDF is available to Subscribers Only