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T. Larson, B. Gaynes, M. MaCumber; Assessment of Foveal Thickness Using Optical Coherence Tomography (OCT) of Aids Patients With Inactive Cytomegaloviral Retinitis; Correlation Between Vision, Contrast Sensitivity and Grade of Previous Retinitis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3070.
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To describe the relationship between inactive CMV retinitis, foveal thickness, visual acuity and contrast sensitivity based on criteria developed by the Studies of the Ocular Complications of AIDS (SOCA) Research Group defining criteria for clinical assessment of the grade and zone of inactive CMV retinitis involvement.
A prospective, longitudinal assessment was performed utilizing consecutively enrolled patients with a proven diagnosis of AIDS and documented inactive CMV retinitis. Visual acuity was determined using a standardized ETDRS based format with contrast sensitivity measured using a Peli–Robson chart at 1 meter. Foveal thickness was determined using a Zeiss Stratus OCT 3 with the fast macular assessment analysis. Individuals with known diabetes mellitus were excluded from study.
Of eight eyes eligible for study, 50% demonstrated a statistically significant asymmetry in foveal thickness (p< 0.05). Of eyes with foveal asymmetry, 3 were bilateral pseudophakes, one was phakic. Loss of either visual acuity or contrast sensitivity was consistent with increased foveal thickness in each of two patients with foveal thickness asymmetry. Only one patient demonstrated a statistically significant correlation between increased foveal thickness and loss of vision as well as contrast sensitivity. Among patients with foveal thickness asymmetry, the most common zone of CMV involvement was 2 and 3 with a grade of involvement ranging from 5–25%. In all but one patient a thicker fovea was present in the eye with more advanced inactive retinitis. Interestingly, diminished vision and contrast was found in one patient with a 5% zone 1 involvement in conjunction with markedly reduced rather than increased foveal thickness (average foveal thickness, 151 microns).
An increase in foveal thickness appears to be related to inactive CMV retinitis not involving the posterior pole and may be responsible for loss of visual function in AIDS patients. Inactive CMV retinitis involving the macula may result in retinal thinning as an inflammatory seqeuala. Subject enrollment continues in this pilot study and will strengthen future data assessment.
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