de Smet MD, Podgor MJ, Belfort R, Lane C, Nussenblatt RB; International Conference on AIDS.
Int Conf AIDS. 1993 Jun 6-11; 9: 315 (abstract no. PO-B06-1076).
Laboratory of Immunology, National Eye Institute, Bethesda, MD 20892.
CMV retinitis is the most common ocular infection seen in AIDS. Therapy is limited at present to virostatic agents with the reactivation rate being 80% or more over 12 months. Thus, early detection and initiation of therapy is indicated, as it may lessen the likelihood of developing severe visual impairment. Presently, screening for retinitis is both time consuming and costly as it must be performed by adequately trained Ophthalmologists. A simple device that could be used by non specialists would be useful. We tested a laser photometer developed by KOWA, to determine if it is capable of detecting the anterior chamber inflammation (aqueous flare) which is associated with CMV retinitis. Eighty AIDS patients were tested (71 controls and 9 CMV). Patients with CMV retinitis had, on average, significantly higher aqueous flare measurements than patients without CMV (p = 0.006 t-test). This difference was not due to age, race or eye color differences between the two groups. A cut off value of 6.3 photon counts gave a sensitivity of 0.889 and a specificity of 0.831. Assuming a CMV prevalence of 20%, the positive predictive value (PPV) was 0.57, while the negative predictive value was 0.97. We conclude that the slit lamp photometer is a potentially good screening device for CMV retinitis that can be used by non Ophthalmologist. Since the PPV was only 0.57, patients that are found to have an increased photon count should be referred to a qualified Ophthalmologist for further evaluation.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Aqueous Humor
- Cytomegalovirus Retinitis
- Eye Diseases
- Eye Infections
- Humans
- Lasers
- Photometry
- Prevalence
- Retinitis
- instrumentation
Other ID:
UI: 102203971
From Meeting Abstracts