PU Conference Series: Euretina 2018

Researchers Identify Three Resolution Patterns of Cytomegalovirus Retinitis Patients with low initial CD4 level had higher chances of developing scarring after treatment completion. N ew research has identified three charac- teristic resolution patterns after treatment of cytomegalovirus retinitis. The identified

69.1% of cytomegalovirus retinitis lesions were fulmi- nant, 29.1% were granular, and 1.8% of patients had frosted branch angiitis, Dr. Jumroendararasame noted in his abstract. The CD4 levels ranged from 4 to 477 cells/µL (75% ≤ 100 cells/µL). After treatment, three healing patterns were identified comprising disappearing (12.7%), scarring (76.4%), and calcific plaque (10.9%). The CD4 level (P = .022), presenting cytomegalovirus retinitis type (P = .007), and initial lesion size (P = .006) were all found to be associ- ated with these resolution patterns. Patients with a low initial CD4 level (< 100 cells/µL) had a higher chance of developing scarring after treatment completion, with an odds ratio of 6.2 (confidence interval 1.52–25.41). In a comment on the findings, Joseph W. Sassani MD, of the Penn State Hershey Eye Center, who was not involved in the study, told Elsevier’s PracticeUpdate that, “importantly initial CD4 level, presenting cytomegalovirus retinitis type, and initial lesion size were associated with the pattern of res- olution. Of particular significance was the finding that a low CD4 level was associated with a higher chance of scarring following treatment. The results of this study should prove helpful to clinicians in planning treatment and in advising patients as to the most likely treatment outcome.”

patterns are disappearing, scarring, and calcific plaque, and the findings were presented at EURETINA 2018. Cytomegalovirus retinitis, characterized by pro- gressive, necrotizing retinitis, is an inflammation of the retina that can result in blindness. The condition is caused by human cytomegalovirus, a member of a group of herpes-type viruses. While most people are exposed to cytomegalovirus retinitis in their lifetime, usually only those with a weakened immune system will become ill from the infection, including individuals with HIV/AIDS, those who have had a bone marrow transplant or organ transplant, or patients undergoing chemotherapy. The retrospective analytic study, led by Chaisiri Jumroendararasame, MD, from Phramongkutklao College of Medicine in Bangkok, Thailand, looked at patients who had been treated in the cytomeg- alovirus retinitis clinic at Phramongkutklao Hospital between December 2014 and August 2017. In all, 78 eyes were enrolled; 57.1% of the patients were male. The mean age was 40.5 years. Initial and final visual acuity varied from 20/20 to light perception. After treatment, 43.6% of the patients had visual improvement, but for 38.2%, their condition wors- ened, while 18.2%were unchanged. At presentation,

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PRACTICEUPDATE CONFERENCE SERIES • EURETINA 2018 16