The Diagnosis of Intraocular Inflammation and Cytomegalovirus Retinitis in HIV-Infected Patients by Laser Flare Photometry Laser Flare Photometry in HIV-Infected Patients

Abstract

Purpose: To assess the sensitivity and specificity of the Kowa Laser Flare Photometer in screening for intraocular inflammation and cytomegalovirus retinitis in HIV-infected patients. Patients and methods: Using the Kowa Flare-Cell 1000, 142 HIV-infected patients were evaluated for aqueous flare. Results: Patients with posterior segment disease had higher flare values (p<0.0001). A specificity of 93% and a sensitivity of 75% was found (cutoff value of 8 photon counts/msec). For a cutoff value of 5 photon counts/msec a specificity of 59% and a sensitivity of 91% was found. Patients with cytomegalovirus retinitis had higher flare values (p<0.0001). A specificity of 86% and a sensitivity of 75% was found for the cutoff value of 8 photon counts/msec and respectively of 53% and 91% for a cutoff value of 5 photon counts/msec. Assuming a 30% prevalence of cytomegalovirus retinitis in the HIV-infected population, positive predictive values of 70% (cutoff value of 8 photon counts/msec) and 45% (cutoff value of 5 photon counts/msec) were estimated. Conclusions: The clinical use of laser flare photometry may assist in the diagnosis of intraocular inflammation in HIV-infected patients. The authors recommend screening of HIV-infected patients by laser flare photometry, and, if high flare values are detected, they recommend that such patients have a full eye examination and be considered at risk of having more extensive disease. This technique does not replace a full ophthalmological examination if there are predisposing visual complaints.

Key Words:

• Acquired Immunodeficiency Syndrome
• cytomegalovirus retinitis
• intraocular inflammation
• photometry
• retinitis
• uveitis