Risk factors for advancement of cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome

Janet Teresa Holbrook, Matthew D. Davis, Larry D. Hubbard, Barbara K. Martin, Gary N. Holland, Douglas Jabs, Adele Kaplan Gilpin, Curtis L Meinert, Daniel S. Reshef

Research output: Contribution to journalArticle

Abstract

Objective: To identify ocular and systemic factors that predict advancement of cytomegalovirus (CMV) retinitis during treatment. Methods: Patients with acquired immunodeficiency syndrome were enrolled in a multicenter clinical trial designed to evaluate foscarnet sodium and ganciclovir sodium as therapy for newly diagnosed CMV retinitis. Ocular characteristics at baseline and measurements of retinitis were assessed from fundus photographs by graders at a fundus photograph reading center. The following measures of advancement were assessed: (1) lesion border movement of at least 750 μm or development of a new lesion in involved eyes; (2) rate of increase in retinal area with CMV in involved eyes; and (3) development of retinitis in uninvolved eyes of patients with unilateral disease at baseline. Results: In eyes with retinitis, risk factors at baseline for advancement while receiving treatment included smaller area involved, active margins of retinitis, and posterior location. Risk factors for development of retinitis in uninvolved fellow eyes included blood and urine cultures positive for CMV and lower CD8 + T-lymphocyte count. Conclusions: Lesion characteristics can be used to predict advancement of preexisting disease, whereas only systemic factors are associated with development of bilateral disease. These analyses describe retinitis activity before the introduction of potent antiretroviral therapies but provide an important reference point for patients in whom CMV retinitis develops after failure or intolerance of antiretroviral agents.

Original languageEnglish (US)
Pages (from-to)1196-1204
Number of pages9
JournalArchives of Ophthalmology
Volume118
Issue number9
StatePublished - 2000

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Cytomegalovirus Retinitis
Retinitis
Acquired Immunodeficiency Syndrome
Cytomegalovirus
Anti-Retroviral Agents
Foscarnet
Preexisting Condition Coverage
Ganciclovir
Lymphocyte Count
Therapeutics
Multicenter Studies
Reading
Clinical Trials
Urine
T-Lymphocytes

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Holbrook, J. T., Davis, M. D., Hubbard, L. D., Martin, B. K., Holland, G. N., Jabs, D., ... Reshef, D. S. (2000). Risk factors for advancement of cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome. Archives of Ophthalmology, 118(9), 1196-1204.

Risk factors for advancement of cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome. / Holbrook, Janet Teresa; Davis, Matthew D.; Hubbard, Larry D.; Martin, Barbara K.; Holland, Gary N.; Jabs, Douglas; Gilpin, Adele Kaplan; Meinert, Curtis L; Reshef, Daniel S.

In: Archives of Ophthalmology, Vol. 118, No. 9, 2000, p. 1196-1204.

Research output: Contribution to journalArticle

Holbrook, JT, Davis, MD, Hubbard, LD, Martin, BK, Holland, GN, Jabs, D, Gilpin, AK, Meinert, CL & Reshef, DS 2000, 'Risk factors for advancement of cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome', Archives of Ophthalmology, vol. 118, no. 9, pp. 1196-1204.
Holbrook, Janet Teresa ; Davis, Matthew D. ; Hubbard, Larry D. ; Martin, Barbara K. ; Holland, Gary N. ; Jabs, Douglas ; Gilpin, Adele Kaplan ; Meinert, Curtis L ; Reshef, Daniel S. / Risk factors for advancement of cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome. In: Archives of Ophthalmology. 2000 ; Vol. 118, No. 9. pp. 1196-1204.
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