Ocular complications of AIDS, particularly cytomegalovirus (CMV) retinitis are associated with poor visual outcomes, impaired quality of life, and high treatment costs. Secular trends in HIV disease management, such as the use of highly active antiretroviral therapy, are altering the epidemiology of these ocular complications, but have not eliminated them. Accordingly, the primary goals of the Studies of Ocular Complications of AIDS (SOCA) Research Group, organized in response to a request for application from the National Eye Institute, are: 1) to evaluate strategies for the treatment of and, when indicated, the prevention of CMV retinitis via randomized, controlled clinical trials; and 2) to investigate the changing epidemiology of the ocular complications of AIDS, in particular, to identify subpopulations at high risk for CMV retinitis and other ocular complications. A related goal of the SOCA Research Group is to investigate the pathogenesis of CMV retinitis, including the relationship between HIV and CMV. Current and proposed studies include: 1) the ongoing Ganciclovir- Cidofovir Cytomegalovirus Retinitis Trial, a randomized controlled clinical trial comparing cidofovir to a regimen of the ganciclovir implant and the oral ganciclovir for the treatment of CMV retinitis; and 2) a longitudinal observational study of the ocular complications of AIDS to assess the impact of secular trends in AIDS management on the incidence and clinical course of these ocular complications over time. Outcomes of interest include visual acuity, visual field, photographic assessments, quality of life, cost effectiveness, and virologic outcomes such as CMV viral load and HIV viral load. This application is for the Fundus Photograph Reading Center of the Studies of Ocular Complications of AIDS.
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