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D.T. Goldenberg, G.N. Holland, M.L. Van Natta, L.D. Hubbard, Studies of Ocular Complications of AIDS Rsch Group; Factors Related to the Opacity of Cytomegalovirus Retinitis Lesions in Patients with AIDS . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3129.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Cytomegalovirus (CMV) retinitis lesion border opacity (whiteness) is believed to be a reflection of virus activity. The intensity of opacity varies between patients, but the reasons for the observed differences have not been fully explained. We sought to identify host factors that are related to severity of lesion border opacification in untreated patients. Methods: In a retrospective review, we identified 11 individuals among subjects in the Longitudinal Studies of the Ocular Complications of AIDS (LSOCA) database who had newly diagnosed CMV retinitis and were not being treated with highly active antiretroviral therapy (HAART) or any specific anti-CMV medication. We compared severity of lesion border opacification to the following factors: zone of involvement and various measures of immune function. Opacity was graded by masked readers at the Fundus Photograph Reading Center using a seven-point scale. Results: Our results confirm a previous observation that lesions in zone 1 (macula and peripapillary areas) are associated with greater degrees of opacification. In addition, the following relationships were identified between severity of opacification and measures of immune function: inverse relationships with CD8+ T-lymphocyte count (p=0.03) and CD4+ T-lymphocyte count (p=0.06); and a direct relationship with HIV blood level (p=0.03). Conclusion: The severity of CMV retinitis lesion border opacification may reflect levels of immune function through an effect on virus activity. Further studies of lesion characteristics may provide a better understanding of host-virus interactions. The appearance of lesions at diagnosis may also have prognostic significance.
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