Retinal detachment associated with aids-related cytomegalovirus retinitis: Risk factors in a resource-limited setting

Michael Yen, Jenny Chen, Somsanguan Ausayakhun, Paradee Kunavisarut, Pornpattana Vichitvejpaisal, Sakarin Ausayakhun, Choeng Jirawison, Jessica Shantha, Gary N. Holland, David Heiden, Todd P. Margolis, Jeremy D. Keenan

Research output: Contribution to journalArticle

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Abstract

Purpose To determine risk factors predictive of retinal detachment in patients with cytomegalovirus (CMV) retinitis in a setting with limited access to ophthalmic care. Design Case-control study. Methods Sixty-four patients with CMV retinitis and retinal detachment were identified from the Ocular Infectious Diseases and Retina Clinics at Chiang Mai University. Three control patients with CMV retinitis but no retinal detachment were selected for each case, matched by calendar date. The medical records of each patient were reviewed, with patient-level and eye-level features recorded for the clinic visit used to match cases and controls, and also for the initial clinic visit at which CMV retinitis was diagnosed. Risk factors for retinal detachment were assessed separately for each of these time points using multivariate conditional logistic regression models that included 1 eye from each patient. Results Patients with a retinal detachment were more likely than controls to have low visual acuity (odds ratio [OR], 1.24 per line of worse vision on the logMAR scale; 95% confidence interval [CI], 1.16-1.33) and bilateral disease (OR, 2.12; 95% CI, 0.92-4.90). Features present at the time of the initial diagnosis of CMV retinitis that predicted subsequent retinal detachment included bilateral disease (OR, 2.68; 95% CI, 1.18-6.08) and lesion size (OR, 2.64 per 10% increase in lesion size; 95% CI, 1.41-4.94). Conclusion Bilateral CMV retinitis and larger lesion sizes, each of which is a marker of advanced disease, were associated with subsequent retinal detachment. Earlier detection and treatment may reduce the likelihood that patients with CMV retinitis develop a retinal detachment.

Original languageEnglish (US)
Pages (from-to)185-192
Number of pages8
JournalAmerican Journal of Ophthalmology
Volume159
Issue number1
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Cytomegalovirus Retinitis
Retinal Detachment
Odds Ratio
Confidence Intervals
Ambulatory Care
Logistic Models
Eye Diseases
Visual Acuity
Medical Records
Communicable Diseases
Retina
Case-Control Studies

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Retinal detachment associated with aids-related cytomegalovirus retinitis : Risk factors in a resource-limited setting. / Yen, Michael; Chen, Jenny; Ausayakhun, Somsanguan; Kunavisarut, Paradee; Vichitvejpaisal, Pornpattana; Ausayakhun, Sakarin; Jirawison, Choeng; Shantha, Jessica; Holland, Gary N.; Heiden, David; Margolis, Todd P.; Keenan, Jeremy D.

In: American Journal of Ophthalmology, Vol. 159, No. 1, 01.01.2015, p. 185-192.

Research output: Contribution to journalArticle

Yen, M, Chen, J, Ausayakhun, S, Kunavisarut, P, Vichitvejpaisal, P, Ausayakhun, S, Jirawison, C, Shantha, J, Holland, GN, Heiden, D, Margolis, TP & Keenan, JD 2015, 'Retinal detachment associated with aids-related cytomegalovirus retinitis: Risk factors in a resource-limited setting', American Journal of Ophthalmology, vol. 159, no. 1, pp. 185-192. https://doi.org/10.1016/j.ajo.2014.10.014
Yen, Michael ; Chen, Jenny ; Ausayakhun, Somsanguan ; Kunavisarut, Paradee ; Vichitvejpaisal, Pornpattana ; Ausayakhun, Sakarin ; Jirawison, Choeng ; Shantha, Jessica ; Holland, Gary N. ; Heiden, David ; Margolis, Todd P. ; Keenan, Jeremy D. / Retinal detachment associated with aids-related cytomegalovirus retinitis : Risk factors in a resource-limited setting. In: American Journal of Ophthalmology. 2015 ; Vol. 159, No. 1. pp. 185-192.
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abstract = "Purpose To determine risk factors predictive of retinal detachment in patients with cytomegalovirus (CMV) retinitis in a setting with limited access to ophthalmic care. Design Case-control study. Methods Sixty-four patients with CMV retinitis and retinal detachment were identified from the Ocular Infectious Diseases and Retina Clinics at Chiang Mai University. Three control patients with CMV retinitis but no retinal detachment were selected for each case, matched by calendar date. The medical records of each patient were reviewed, with patient-level and eye-level features recorded for the clinic visit used to match cases and controls, and also for the initial clinic visit at which CMV retinitis was diagnosed. Risk factors for retinal detachment were assessed separately for each of these time points using multivariate conditional logistic regression models that included 1 eye from each patient. Results Patients with a retinal detachment were more likely than controls to have low visual acuity (odds ratio [OR], 1.24 per line of worse vision on the logMAR scale; 95{\%} confidence interval [CI], 1.16-1.33) and bilateral disease (OR, 2.12; 95{\%} CI, 0.92-4.90). Features present at the time of the initial diagnosis of CMV retinitis that predicted subsequent retinal detachment included bilateral disease (OR, 2.68; 95{\%} CI, 1.18-6.08) and lesion size (OR, 2.64 per 10{\%} increase in lesion size; 95{\%} CI, 1.41-4.94). Conclusion Bilateral CMV retinitis and larger lesion sizes, each of which is a marker of advanced disease, were associated with subsequent retinal detachment. Earlier detection and treatment may reduce the likelihood that patients with CMV retinitis develop a retinal detachment.",
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AU - Yen, Michael

AU - Chen, Jenny

AU - Ausayakhun, Somsanguan

AU - Kunavisarut, Paradee

AU - Vichitvejpaisal, Pornpattana

AU - Ausayakhun, Sakarin

AU - Jirawison, Choeng

AU - Shantha, Jessica

AU - Holland, Gary N.

AU - Heiden, David

AU - Margolis, Todd P.

AU - Keenan, Jeremy D.

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N2 - Purpose To determine risk factors predictive of retinal detachment in patients with cytomegalovirus (CMV) retinitis in a setting with limited access to ophthalmic care. Design Case-control study. Methods Sixty-four patients with CMV retinitis and retinal detachment were identified from the Ocular Infectious Diseases and Retina Clinics at Chiang Mai University. Three control patients with CMV retinitis but no retinal detachment were selected for each case, matched by calendar date. The medical records of each patient were reviewed, with patient-level and eye-level features recorded for the clinic visit used to match cases and controls, and also for the initial clinic visit at which CMV retinitis was diagnosed. Risk factors for retinal detachment were assessed separately for each of these time points using multivariate conditional logistic regression models that included 1 eye from each patient. Results Patients with a retinal detachment were more likely than controls to have low visual acuity (odds ratio [OR], 1.24 per line of worse vision on the logMAR scale; 95% confidence interval [CI], 1.16-1.33) and bilateral disease (OR, 2.12; 95% CI, 0.92-4.90). Features present at the time of the initial diagnosis of CMV retinitis that predicted subsequent retinal detachment included bilateral disease (OR, 2.68; 95% CI, 1.18-6.08) and lesion size (OR, 2.64 per 10% increase in lesion size; 95% CI, 1.41-4.94). Conclusion Bilateral CMV retinitis and larger lesion sizes, each of which is a marker of advanced disease, were associated with subsequent retinal detachment. Earlier detection and treatment may reduce the likelihood that patients with CMV retinitis develop a retinal detachment.

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