SCREENING FOR CYTOMEGALOVIRUS RETINITIS IN HIV-POSITIVE AND AIDS PATIENTS

The ability of physicians to screen for AIDS-related cytomegalovirus r etinitis (CMVR) was studied at a London AIDS centre. Patients had unde rgone direct ophthalmoscopy as part of their general examination by th e physicians and were referred if fundal abnormalities were found, if a focus of extra-ocular CMVR was present or if the patient complained of visual symptoms. The provisional diagnoses of the physicians were c ompared with the final diagnoses of the ophthalmologists. Of 348 conse cutive patients referred for an ophthalmic opinion, the physicians mad e the correct diagnosis in 69% of those referred with a provisional di agnosis of CMVR, in 66% of those with normal fundi and in 81% of those with toxoplasma chorioretinitis. Those cases of CMVR which were misdi agnosed by the physicians were usually mistaken for other retinal path ology which would warrant a specialist referral. Screening for CMVR in HIV-positive and AIDS patients may safely be undertaken by physicians familiar with the ocular manifestations of HIV-related disease.