Clinical features of newly diagnosed cytomegalovirus retinitis in Northern Thailand

Purpose: To characterize the clinical manifestations of cytomegalovirus (CMV) retinitis in northern Thailand. Design: Prospective, observational, cross-sectional study. Methods: We recorded characteristics of 52 consecutive patients newly diagnosed with CMV retinitis at a tertiary university-based m...

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Main Authors: Somsanguan Ausayakhun, Jeremy D. Keenan, Sakarin Ausayakhun, Choeng Jirawison, Claire M. Khouri, Alison H. Skalet, David Heiden, Gary N. Holland, Todd P. Margolis
Format: Journal
Published: 2018
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spelling th-cmuir.6653943832-518992018-09-04T06:11:26Z Clinical features of newly diagnosed cytomegalovirus retinitis in Northern Thailand Somsanguan Ausayakhun Jeremy D. Keenan Sakarin Ausayakhun Choeng Jirawison Claire M. Khouri Alison H. Skalet David Heiden Gary N. Holland Todd P. Margolis Medicine Purpose: To characterize the clinical manifestations of cytomegalovirus (CMV) retinitis in northern Thailand. Design: Prospective, observational, cross-sectional study. Methods: We recorded characteristics of 52 consecutive patients newly diagnosed with CMV retinitis at a tertiary university-based medical center in northern Thailand. Indirect ophthalmoscopy by experienced ophthalmologists was supplemented with fundus photography to determine the proportion of eyes with various clinical features of CMV retinitis. Results: Of the 52 patients with CMV retinitis, 55.8% were female. All were HIV-positive. The vast majority (90.4%) had started antiretroviral therapy. CMV retinitis was bilateral in 46.2% of patients. Bilateral visual acuity worse than 20/60 was observed in 23.1% of patients. Of 76 eyes with CMV retinitis, 61.8% had zone I disease and 21.6% had lesions involving the fovea. Lesions larger than 25% of the retinal area were observed in 57.5% of affected eyes. CMV retinitis lesions commonly had marked or severe border opacity (47.4% of eyes). Vitreous haze often was present (46.1% of eyes). Visual impairment was more common in eyes with larger retinitis lesions. Retinitis lesion size, used as a proxy for duration of disease, was associated with fulminant appearance (odds ratio, 1.24; 95% confidence interval, 1.01 to 1.51) and marked or severe border opacity (odds ratio, 1.36; 95% confidence interval, 1.11 to 1.67). Based on lesion size, retinitis preceded antiretroviral treatment in each patient. Conclusions: Patients seeking treatment at a tertiary medical center in northern Thailand had advanced CMV retinitis, possibly because of delayed diagnosis. Earlier screening and treatment of CMV retinitis may limit progression of disease and may prevent visual impairment in this population. © 2012 Elsevier Inc. All Rights Reserved. 2018-09-04T06:11:26Z 2018-09-04T06:11:26Z 2012-05-01 Journal 18791891 00029394 2-s2.0-84859794212 10.1016/j.ajo.2011.10.012 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84859794212&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/51899
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
Somsanguan Ausayakhun
Jeremy D. Keenan
Sakarin Ausayakhun
Choeng Jirawison
Claire M. Khouri
Alison H. Skalet
David Heiden
Gary N. Holland
Todd P. Margolis
Clinical features of newly diagnosed cytomegalovirus retinitis in Northern Thailand
description Purpose: To characterize the clinical manifestations of cytomegalovirus (CMV) retinitis in northern Thailand. Design: Prospective, observational, cross-sectional study. Methods: We recorded characteristics of 52 consecutive patients newly diagnosed with CMV retinitis at a tertiary university-based medical center in northern Thailand. Indirect ophthalmoscopy by experienced ophthalmologists was supplemented with fundus photography to determine the proportion of eyes with various clinical features of CMV retinitis. Results: Of the 52 patients with CMV retinitis, 55.8% were female. All were HIV-positive. The vast majority (90.4%) had started antiretroviral therapy. CMV retinitis was bilateral in 46.2% of patients. Bilateral visual acuity worse than 20/60 was observed in 23.1% of patients. Of 76 eyes with CMV retinitis, 61.8% had zone I disease and 21.6% had lesions involving the fovea. Lesions larger than 25% of the retinal area were observed in 57.5% of affected eyes. CMV retinitis lesions commonly had marked or severe border opacity (47.4% of eyes). Vitreous haze often was present (46.1% of eyes). Visual impairment was more common in eyes with larger retinitis lesions. Retinitis lesion size, used as a proxy for duration of disease, was associated with fulminant appearance (odds ratio, 1.24; 95% confidence interval, 1.01 to 1.51) and marked or severe border opacity (odds ratio, 1.36; 95% confidence interval, 1.11 to 1.67). Based on lesion size, retinitis preceded antiretroviral treatment in each patient. Conclusions: Patients seeking treatment at a tertiary medical center in northern Thailand had advanced CMV retinitis, possibly because of delayed diagnosis. Earlier screening and treatment of CMV retinitis may limit progression of disease and may prevent visual impairment in this population. © 2012 Elsevier Inc. All Rights Reserved.
format Journal
author Somsanguan Ausayakhun
Jeremy D. Keenan
Sakarin Ausayakhun
Choeng Jirawison
Claire M. Khouri
Alison H. Skalet
David Heiden
Gary N. Holland
Todd P. Margolis
author_facet Somsanguan Ausayakhun
Jeremy D. Keenan
Sakarin Ausayakhun
Choeng Jirawison
Claire M. Khouri
Alison H. Skalet
David Heiden
Gary N. Holland
Todd P. Margolis
author_sort Somsanguan Ausayakhun
title Clinical features of newly diagnosed cytomegalovirus retinitis in Northern Thailand
title_short Clinical features of newly diagnosed cytomegalovirus retinitis in Northern Thailand
title_full Clinical features of newly diagnosed cytomegalovirus retinitis in Northern Thailand
title_fullStr Clinical features of newly diagnosed cytomegalovirus retinitis in Northern Thailand
title_full_unstemmed Clinical features of newly diagnosed cytomegalovirus retinitis in Northern Thailand
title_sort clinical features of newly diagnosed cytomegalovirus retinitis in northern thailand
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84859794212&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/51899
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