CYTOMEGALOVIRUS RETINITIS AND AIDS IN EDINBURGH

The medical records, retinal drawings and fundus photographs of all pa tients with cytomegalovirus retinitis (CMVR) and AIDS in Edinburgh bet ween 1986-1992 were reviewed to determine the efficacy of treatment in preserving vision. Ophthalmoscopic features of CMVR were observed in 32 eyes of 24 patients with AIDS, 19 males and 5 females. HIV transmis sion in this group was by homo/bisexual contact (16), injection drug u se (7) and blood transfusion (1). Unilateral blurring was the commones t visual symptom although 9 (38%) patients had no visual symptoms. All patients presented with a corrected visual acuity of 6/12 or better i n at least one eye. Following treatment with systemic ganciclovir or f oscarnet 16 patients (66%) developed toxic side-effects of therapy and 13 (54%) experienced a recurrence of CMVR. Four (17%) patients develo ped a retinal detachment in one eye. The mean survival was 8.3 months after the diagnosis of CMVR. At final follow-up, between 2-26 months a fter the diagnosis of CMVR, 21 (87.5%) patients retained useful vision (6/18 or better) although 3 (12.5%) were effectively blind (less than 6/60). We conclude that with prompt diagnosis and treatment of CMVR v ision can be preserved in the majority of cases.