Skip to main content
PMC home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1998 Jul;82(7):748–750. doi: 10.1136/bjo.82.7.748

Risk of developing CMV retinitis following non-ocular CMV end organ disease in AIDS patients

F Verbraak 1, G J van den Horn 1, J T M van der Meer 1, D Paydafar 1, K ten 1, P Dillen 1, A Kijlstra 1
PMCID: PMC1722657  PMID: 9924364

Abstract

AIM—To describe the risk of developing cytomegalovirus (CMV) retinitis after a first episode of extraocular CMV disease in AIDS patients.
METHODS—A review of the clinical records of 20 AIDS patients, without CMV retinitis, with histologically confirmed extraocular CMV disease, was performed. The main outcome measures were occurrence of CMV retinitis, time to development of CMV retinitis, relation to maintenance therapy, and survival.
RESULTS—A CMV retinitis was diagnosed in 17 of 20 (85%) patients with an immunohistologically confirmed diagnosis of extraocular CMV disease after a mean follow up of 6.4 months. Four patients received maintenance therapy. Three of them developed retinitis after a mean of 9.6 months (range 2-16 months). Sixteen did not receive maintenance and retinitis was diagnosed in 14 of them after a mean of 5.7 months (range 2-11 months). Mean survival was 9.9 months after the diagnosis of extraocular disease, and 4.5 months after the diagnosis of retinitis. In the four patients receiving maintenance therapy, mean survival was 11.5 months, and in the 16 other patients mean survival was 9.5 months. Patients did not receive protease inhibitors.
CONCLUSION—In the preprotease inhibitor era extraocular CMV disease strongly predisposes to the subsequent development of CMV retinitis. Although maintenance therapy did not prevent the occurrence of retinitis, the time period between both events seems to lengthen considerably. In patients receiving maintenance survival is also longer. 

 Keywords: cytomegalovirus retinitis; risk factor; extraocular CMV disease; maintenance therapy

Full Text

The Full Text of this article is available as a PDF (79.9 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blanshard C., Benhamou Y., Dohin E., Lernestedt J. O., Gazzard B. G., Katlama C. Treatment of AIDS-associated gastrointestinal cytomegalovirus infection with foscarnet and ganciclovir: a randomized comparison. J Infect Dis. 1995 Sep;172(3):622–628. doi: 10.1093/infdis/172.3.622. [DOI] [PubMed] [Google Scholar]
  2. Chui D. W., Owen R. L. AIDS and the gut. J Gastroenterol Hepatol. 1994 May-Jun;9(3):291–303. doi: 10.1111/j.1440-1746.1994.tb01729.x. [DOI] [PubMed] [Google Scholar]
  3. Dieterich D. T., Kotler D. P., Busch D. F., Crumpacker C., Du Mond C., Dearmand B., Buhles W. Ganciclovir treatment of cytomegalovirus colitis in AIDS: a randomized, double-blind, placebo-controlled multicenter study. J Infect Dis. 1993 Feb;167(2):278–282. doi: 10.1093/infdis/167.2.278. [DOI] [PubMed] [Google Scholar]
  4. Dieterich D. T., Rahmin M. Cytomegalovirus colitis in AIDS: presentation in 44 patients and a review of the literature. J Acquir Immune Defic Syndr. 1991;4 (Suppl 1):S29–S35. [PubMed] [Google Scholar]
  5. Gallant J. E., Moore R. D., Richman D. D., Keruly J., Chaisson R. E. Incidence and natural history of cytomegalovirus disease in patients with advanced human immunodeficiency virus disease treated with zidovudine. The Zidovudine Epidemiology Study Group. J Infect Dis. 1992 Dec;166(6):1223–1227. doi: 10.1093/infdis/166.6.1223. [DOI] [PubMed] [Google Scholar]
  6. Hoover D. R., Peng Y., Saah A., Semba R., Detels R. R., Rinaldo C. R., Jr, Phair J. P. Occurrence of cytomegalovirus retinitis after human immunodeficiency virus immunosuppression. Arch Ophthalmol. 1996 Jul;114(7):821–827. doi: 10.1001/archopht.1996.01100140035004. [DOI] [PubMed] [Google Scholar]
  7. Mentec H., Leport C., Leport J., Marche C., Harzic M., Vildé J. L. Cytomegalovirus colitis in HIV-1-infected patients: a prospective research in 55 patients. AIDS. 1994 Apr;8(4):461–467. doi: 10.1097/00002030-199404000-00007. [DOI] [PubMed] [Google Scholar]
  8. Salomon N., Gomez T., Perlman D. C., Laya L., Eber C., Mildvan D. Clinical features and outcomes of HIV-related cytomegalovirus pneumonia. AIDS. 1997 Mar;11(3):319–324. doi: 10.1097/00002030-199703110-00009. [DOI] [PubMed] [Google Scholar]
  9. Spector S. A., McKinley G. F., Lalezari J. P., Samo T., Andruczk R., Follansbee S., Sparti P. D., Havlir D. V., Simpson G., Buhles W. Oral ganciclovir for the prevention of cytomegalovirus disease in persons with AIDS. Roche Cooperative Oral Ganciclovir Study Group. N Engl J Med. 1996 Jun 6;334(23):1491–1497. doi: 10.1056/NEJM199606063342302. [DOI] [PubMed] [Google Scholar]
  10. Sutton F. M., Graham D. Y., Goodgame R. W. Infectious esophagitis. Gastrointest Endosc Clin N Am. 1994 Oct;4(4):713–729. [PubMed] [Google Scholar]
  11. d'Arminio Monforte A., Mainini F., Testa L., Vago L., Balotta L., Nebuloni M., Antinori S., Bini T., Moroni M. Predictors of cytomegalovirus disease, natural history and autopsy findings in a cohort of patients with AIDS. AIDS. 1997 Mar 15;11(4):517–524. doi: 10.1097/00002030-199704000-00016. [DOI] [PubMed] [Google Scholar]
  12. van der Meer J. T., Drew W. L., Bowden R. A., Galasso G. J., Griffiths P. D., Jabs D. A., Katlama C., Spector S. A., Whitley R. J. Summary of the International Consensus Symposium on Advances in the Diagnosis, Treatment and Prophylaxis and Cytomegalovirus Infection. Antiviral Res. 1996 Nov;32(3):119–140. doi: 10.1016/s0166-3542(96)01006-6. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES