부산대학교 도서관

Background: Cytomegalovirus retinitis is a neglected disease in resource‐poor settings, in part because of the perceived complexity of care and because ophthalmologists are rarely accessible. In this paper, we describe a pilot programme of CMV retinitis management by non‐ophthalmologists. The programme consists of systematic screening of all high‐risk patients (CD4 Methods: This is a retrospective descriptive study. Between November 2006 and July 2009, 17 primary care AIDS clinicians were trained in indirect ophthalmoscopy and diagnosis of CMV retinitis; eight were also trained in intravitreal injection. Evaluation of training by a variety of methods documented high clinical competence. Systematic screening of all high‐risk patients (CD4 Results: A total of 891 new patients (1782 eyes) were screened in the primary area (Yangon); the majority of patients were male (64.3%), median age was 32 years, and median CD4 cell count was 38 cells/mm[sup.3]. CMV retinitis was diagnosed in 24% (211/891) of these patients. Bilateral disease was present in 36% of patients. Patients with active retinitis were treated with weekly intravitreal injection of ganciclovir, with patients typically receiving five to seven injections per eye. A total of 1296 injections were administered. Conclusions: A strategy of management of CMV retinitis at the primary care level is feasible in resource‐poor settings. With appropriate training and support, CMV retinitis can be diagnosed and treated by AIDS clinicians (non‐ophthalmologists), just like other major opportunistic infections.
Background In south‐east Asia, cytomegalovirus (CMV) retinitis is a neglected disease [1], with no defined strategy for management [2,3]. This is despite evidence that CMV retinitis is a common cause [...]