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Corneal endothelial changes in cytomegalovirus retinitis
S M Mitchell1, K Barton, S Lightman
1Department of Clinical Science, Moorfields Eye Hospital, London, UK.
Eye (London, England)
|January 1, 1994
Summary
Corneal endothelial changes in patients with acquired immune deficiency syndrome (AIDS) can indicate cytomegalovirus (CMV) retinitis. However, these findings are not prevalent enough to reliably screen for CMV retinitis.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Virology
Background:
- Cytomegalovirus (CMV) retinitis is a significant opportunistic infection in patients with acquired immune deficiency syndrome (AIDS).
- Characteristic fundus changes are typical of CMV retinitis, but early detection methods are crucial.
Purpose of the Study:
- To characterize corneal endothelial reticular deposits in AIDS patients using specular microscopy.
- To evaluate the potential of these endothelial changes as a rapid, non-dilating slit-lamp screening tool for CMV retinitis.
Main Methods:
- Sixty male homosexual patients diagnosed with AIDS were examined.
- Corneal endothelium was assessed via slit-lamp microscopy before fundal examination.
- CMV retinitis diagnosis was confirmed by fundal appearance and vitreous sample analysis.
Main Results:
- Corneal endothelial changes were observed in conjunction with CMV retinitis.
- These endothelial changes demonstrated a high positive predictive value (94.7%) for CMV retinitis.
- The negative predictive value was 75.6%, and the changes were not consistently present in all CMV retinitis cases.
Conclusions:
- Corneal endothelial reticular deposits are a strong indicator of CMV retinitis in AIDS patients.
- Despite high specificity, the low prevalence of these changes limits their utility as a standalone screening tool for CMV retinitis in this population.
