Cytomegalovirus retinitis and acquired immunodeficiency syndrome

D. A. Jabs, C. Enger and J. G. Bartlett
Wilmer Ophthalmological Institute, Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21205.

In a series of 157 patients with acquired immunodeficiency syndrome (AIDS), 46 (29%) developed cytomegalovirus (CMV) retinitis. In five patients, CMV retinitis was the initial AIDS-defining opportunistic infection (11% of patients with CMV retinitis and 3% of patients with AIDS). Retinal detachments developed in seven patients (15%) and in four were present before the institution of ganciclovir therapy. Bilateral CMV retinitis was present in 35% of patients at presentation and subsequently developed in nine (60%) of 15 patients while not being treated with ganciclovir. Conversely, none of 18 patients with unilateral disease developed bilateral disease while receiving ganciclovir. Of patients treated with ganciclovir for their CMV retinitis, 81% had a response to the drug, and 61% achieved a complete response, resulting in a nonprogressive and inactive scar. Patients who achieved a complete response with ganciclovir had a significantly longer survival than those who did not, suggesting greater immune compromise in those patients who failed to respond to ganciclovir.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The 100 Most Frequently Cited Articles in Ophthalmology Journals
Ohba et al.
Arch Ophthalmol 2007;125:952-960.
ABSTRACT | FULL TEXT  

Effect of Ganciclovir on the Hydrolytic Degradation of Poly(lactide-co-glycolide) Microspheres
Chen et al.
J Biomater Appl 2006;20:287-302.
ABSTRACT  

Risk of Vision Loss in Patients With Cytomegalovirus Retinitis and the Acquired Immunodeficiency Syndrome
Kempen et al.
Arch Ophthalmol 2003;121:466-476.
ABSTRACT | FULL TEXT  

Discontinuing anticytomegalovirus therapy in patients with cytomegalovirus retinitis and AIDS
JABS
Br. J. Ophthalmol. 2001;85:381-382.
FULL TEXT  

Management and Prevention of Opportunistic Infections in the HIV-Infected Patient
Purdy
Journal of Pharmacy Practice 2000;13:475-498.
ABSTRACT  

Entry of Human Cytomegalovirus into Retinal Pigment Epithelial and Endothelial Cells by Endocytosis
Bodaghi et al.
IOVS 1999;40:2598-2607.
ABSTRACT | FULL TEXT  

Protection against Murine Cytomegalovirus Retinitis by Adoptive Transfer of Virus-Specific CD8+ T Cells
Bigger et al.
IOVS 1999;40:2608-2613.
ABSTRACT | FULL TEXT  

HIV medicine: Cytomegalovirus retinitis in patients with acquired immune deficiency syndrome
Eong et al.
Postgrad. Med. J. 1999;75:585-590.
ABSTRACT | FULL TEXT  

Human Cytomegalovirus and Human Herpesvirus 6 Genes That Transform and Transactivate
Doniger et al.
Clin. Microbiol. Rev. 1999;12:367-382.
ABSTRACT | FULL TEXT  

Role of IFN-{gamma}-Induced Indoleamine 2,3 Dioxygenase and Inducible Nitric Oxide Synthase in the Replication of Human Cytomegalovirus in Retinal Pigment Epithelial Cells
Bodaghi et al.
J. Immunol. 1999;162:957-964.
ABSTRACT | FULL TEXT  

Incidence of Foscarnet Resistance and Cidofovir Resistance in Patients Treated for Cytomegalovirus Retinitis
Jabs et al.
Antimicrob. Agents Chemother. 1998;42:2240-2244.
ABSTRACT | FULL TEXT  

Do all patients with CMV retinitis require life long anti-CMV therapy?
NOLAN and MITCHELL
Br. J. Ophthalmol. 1998;82:841e-841.
FULL TEXT  

NK Cell Modulation of Murine Cytomegalovirus Retinitis
Bigger et al.
J. Immunol. 1998;160:5826-5831.
ABSTRACT | FULL TEXT  

Immune Recovery Vitritis Associated With Inactive Cytomegalovirus Retinitis: A New Syndrome
Karavellas et al.
Arch Ophthalmol 1998;116:169-175.
ABSTRACT | FULL TEXT  

Treatment of Cytomegalovirus Retinitis with a Sustained-Release Ganciclovir Implant
Musch et al.
NEJM 1997;337:83-90.
ABSTRACT | FULL TEXT  

Treatment of Cytomegalovirus Retinitis in Patients with the Acquired Immunodeficiency Syndrome
Jacobson
NEJM 1997;337:105-114.
FULL TEXT  

Ganciclovir
Crumpacker
NEJM 1996;335:721-729.
FULL TEXT  

Oral Ganciclovir for the Prevention of Cytomegalovirus Disease in Persons with AIDS
Spector et al.
NEJM 1996;334:1491-1497.
ABSTRACT | FULL TEXT  

Oral Ganciclovir as Maintenance Treatment for Cytomegalovirus Retinitis in Patients with AIDS
Drew et al.
NEJM 1995;333:615-620.
ABSTRACT | FULL TEXT  

Diseases of the Retina
D'Amico
NEJM 1994;331:95-106.
FULL TEXT