Michael Yen1, Jenny Chen2, Somsanguan Ausayakhun3, Paradee Kunavisarut3, Pornpattana Vichitvejpaisal3, Sakarin Ausayakhun3, Choeng Jirawison4, Jessica Shantha5, Gary N Holland6, David Heiden7, Todd P Margolis8, Jeremy D Keenan9. 1. Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California; Icahn School of Medicine at Mount Sinai, New York, New York. 2. Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California; Ocular Inflammatory Disease Center, Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California. 3. Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. 4. Department of Ophthalmology, Nakornping Hospital, Chiang Mai, Thailand. 5. Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California. 6. Ocular Inflammatory Disease Center, Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California. 7. Department of Ophthalmology and Pacific Vision Foundation, California Pacific Medical Center, San Francisco, California. 8. Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, San Francisco, California. 9. Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, San Francisco, California. Electronic address: jeremy.keenan@ucsf.edu.
Abstract
PURPOSE: To determine risk factors predictive of retinal detachment in patients with cytomegalovirus (CMV) retinitis in a setting with limited access to ophthalmic care. DESIGN: Case-control study. METHODS: Sixty-four patients with CMV retinitis and retinal detachment were identified from the Ocular Infectious Diseases and Retina Clinics at Chiang Mai University. Three control patients with CMV retinitis but no retinal detachment were selected for each case, matched by calendar date. The medical records of each patient were reviewed, with patient-level and eye-level features recorded for the clinic visit used to match cases and controls, and also for the initial clinic visit at which CMV retinitis was diagnosed. Risk factors for retinal detachment were assessed separately for each of these time points using multivariate conditional logistic regression models that included 1 eye from each patient. RESULTS: Patients with a retinal detachment were more likely than controls to have low visual acuity (odds ratio [OR], 1.24 per line of worse vision on the logMAR scale; 95% confidence interval [CI], 1.16-1.33) and bilateral disease (OR, 2.12; 95% CI, 0.92-4.90). Features present at the time of the initial diagnosis of CMV retinitis that predicted subsequent retinal detachment included bilateral disease (OR, 2.68; 95% CI, 1.18-6.08) and lesion size (OR, 2.64 per 10% increase in lesion size; 95% CI, 1.41-4.94). CONCLUSION: Bilateral CMV retinitis and larger lesion sizes, each of which is a marker of advanced disease, were associated with subsequent retinal detachment. Earlier detection and treatment may reduce the likelihood that patients with CMV retinitis develop a retinal detachment.
PURPOSE: To determine risk factors predictive of retinal detachment in patients with cytomegalovirus (CMV) retinitis in a setting with limited access to ophthalmic care. DESIGN: Case-control study. METHODS: Sixty-four patients with CMV retinitis and retinal detachment were identified from the Ocular Infectious Diseases and Retina Clinics at Chiang Mai University. Three control patients with CMV retinitis but no retinal detachment were selected for each case, matched by calendar date. The medical records of each patient were reviewed, with patient-level and eye-level features recorded for the clinic visit used to match cases and controls, and also for the initial clinic visit at which CMV retinitis was diagnosed. Risk factors for retinal detachment were assessed separately for each of these time points using multivariate conditional logistic regression models that included 1 eye from each patient. RESULTS:Patients with a retinal detachment were more likely than controls to have low visual acuity (odds ratio [OR], 1.24 per line of worse vision on the logMAR scale; 95% confidence interval [CI], 1.16-1.33) and bilateral disease (OR, 2.12; 95% CI, 0.92-4.90). Features present at the time of the initial diagnosis of CMV retinitis that predicted subsequent retinal detachment included bilateral disease (OR, 2.68; 95% CI, 1.18-6.08) and lesion size (OR, 2.64 per 10% increase in lesion size; 95% CI, 1.41-4.94). CONCLUSION: Bilateral CMV retinitis and larger lesion sizes, each of which is a marker of advanced disease, were associated with subsequent retinal detachment. Earlier detection and treatment may reduce the likelihood that patients with CMV retinitis develop a retinal detachment.
Authors: D A Wohl; M A Kendall; S Owens; G Holland; M Nokta; S A Spector; R Schrier; S Fiscus; M Davis; M A Jacobson; J S Currier; K Squires; B Alston-Smith; J Andersen; W R Freeman; M Higgins; F J Torriani Journal: HIV Clin Trials Date: 2005 May-Jun
Authors: Gary N Holland; Jean D Vaudaux; Kevin M Shiramizu; Fei Yu; David T Goldenberg; Anurag Gupta; Margrit Carlson; Russell W Read; Roger D Novack; Baruch D Kuppermann Journal: Am J Ophthalmol Date: 2008-01 Impact factor: 5.258
Authors: I Yust; Z Fox; M Burke; A Johnson; D Turner; A Mocroft; C Katlama; B Ledergerber; P Reiss; O Kirk Journal: Eur J Clin Microbiol Infect Dis Date: 2004-06-30 Impact factor: 3.267
Authors: Michael Yen; Somsanguan Ausayakhun; Jenny Chen; Sakarin Ausayakhun; Choeng Jirawison; David Heiden; Gary N Holland; Todd P Margolis; Jeremy D Keenan Journal: JAMA Ophthalmol Date: 2014-09 Impact factor: 7.389