This application is for secondary analyses of data generated by the Studies of Ocular Complications of AIDS (SOCA) Foscarnet-Ganciclovir Cytomegalovirus Retinitis Trial (FGCRT). The FGCRT was a multicenter randomized clinical trial, funded by the National Eye institute, designed to compare foscarnet with ganciclovir in the treatment of cytomegalovirus retinitis in 240 patients with the acquired immunodeficiency syndrome. CMV retinitis is the most common intraocular opportunistic infection in people with AIDS, and left untreated it is potentially blinding. Since people with AIDS are living longer than before, there is a need to identify prognostic indicators for progression of retinitis, and to evaluate measures of retinitis progression in association with long term visual outcomes. We will use the data generated from evaluations of fundus photographs by both a standard grading method and by a digitized planimetric grading method in conjunction with clinical and laboratory data to explore the following areas: l) Evaluation of baseline characteristics of eyes affected by CMV retinitis, as well as clinical characteristics of patients as prognostic indicators for progression of CMV retinitis. 2) Evaluation of alternative approaches for interpretation of retinal photographs, and alternative methods of evaluating retinitis progression. For example, the standard definition of progression of 750 microns of advancement along one dimension will be compared with a planimetrically determined area of increase in lesion size. 3) Examination of the relationship between alternative measures of retinitis progression and subsequent course of disease in terms of survival and visual fields. Three publications are planned: l) Prognostic indicators for cytomegalovirus retinitis, 2) Alternative methods for assessment of cytomegalovirus retinitis, and 3) Correlation of progression of CMV retinitis to visual outcomes and survival.
| Holbrook, Janet T; Jabs, Douglas A; Weinberg, David V et al. (2003) Visual loss in patients with cytomegalovirus retinitis and acquired immunodeficiency syndrome before widespread availability of highly active antiretroviral therapy. Arch Ophthalmol 121:99-107 |
| Holbrook, J T; Meinert, C L; Van Natta, M L et al. (2001) Photographic measures of cytomegalovirus retinitis as surrogates for visual outcomes in treated patients. Arch Ophthalmol 119:554-63 |
| Holbrook, J T; Davis, M D; Hubbard, L D et al. (2000) Risk factors for advancement of cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome. Studies of Ocular Complications of AIDS Research Group. Arch Ophthalmol 118:1196-204 |
