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Use of a Standardized System for the Assessment of Disease Outcome

Gary N. Holland, MD; William C. Buhles, Jr, DVM, PhD; Barbara Mastre, RN; Henry J. Kaplan, MD; the UCLA CMV Retinopathy Study Group

Arch Ophthalmol. 1989;107(12):1759-1766.

Abstract
• To evaluate more accurately the clinical response of cytomegalovirus retinopathy to ganciclovir, a system for the assessment of disease outcome was developed that uses retinal photographs and three factors: development of new lesions, enlargement of preexisting lesions, and change in retinal opacification of lesion borders. With this system a retrospective comparison was performed of 24 ganciclovir-treated patients and 17 untreated patients with cytomegalovirus retinopathy. A masked assessment showed disease progression in 10 treated patients (43%) during a median period of 22 days. In contrast, 16 untreated patients (94%) had progression of disease during a median period of 25 days. Comparison of treated and untreated eyes also suggests that treatment may prevent deterioration of visual acuity during the same period. This study supports the conclusions of previous uncontrolled studies that ganciclovir is beneficial in the treatment of patients with acquired immunodeficiency syndrome and cytomegalovirus retinopathy. It also demonstrates the utility of the proposed system for assessment of disease outcome that can be used in future studies of therapy for necrotizing viral retinopathies.

Author Affiliations
From the AIDS Unit of the UCLA Uveitis Center, the Jules Stein Eye Institute, and the Department of Ophthalmology, UCLA School of Medicine, Los Angeles, Calif (Dr Holland); the Institute of Clinical Medicine, Syntex Research, Palo Alto, Calif (Dr Buhles and Ms Mastre); and the Department of Ophthalmology, Washington University School of Medicine, St Louis, Mo (Dr Kaplan). The names of participating members of the UCLA CMV Retinopathy Study Group appear at the end of this article.

Footnotes
Accepted for publication July 31,1989.

Reprint requests to Jules Stein Eye Institute, UCLA Medical Center, 10833 Le Conte Ave, Los Angeles, CA 90024-1771 (Dr Holland).

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