Incidence Rate and Risk Factors for Contralateral Eye Involvement among Patients with AIDS and Cytomegalovirus Retinitis Treated with Local Therapy

Abstract

Purpose: To calculate the incidence of, and to identify the risk factors for developing contralateral eye involvement among patients with AIDS and unilateral cytomegalovirus retinitis (CMV retinitis), who were treated, in the era of highly-active antiretroviral therapy (HAART), with repetitive intravitreal ganciclovir injections.

Materials and Methods: The clinical records of 119 patients were included. The main outcome measurement was the occurrence of contralateral eye involvement.

Results: Over a mean follow-up period of 1.6 years, the overall incidence rate of contralateral involvement was 0.17/person-year. The cumulative incidence of contralateral involvement at 6 months and 1 year was 23.8% and 28.4%, respectively. Receiving HAART at the visit before the event was associated with a decreased risk of developing contralateral retinitis (hazard ratio [HR] = 0.26, P = 0.002).

Conclusions: The use of HAART, associated with subsequent immune recovery, significantly reduced the incidence of contralateral eye involvement by approximately 75% among patients in our setting.

Keywords:

• AIDS
• contralateral retinitis
• cytomegalovirus retinitis
• Ganciclovir
• local therapy

Acknowledgements

We would like to thank Dr. Alan Geater for his valuable assistance regarding the statistics used in this project. We would also like to thank Ms. Parichat Damthongsuk for her assistance in collecting the data. Finally, we would like to thank Mr. Edmond Subashi for his contribution in English editing.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.