Kumar Anika, Ausayakhun Somsanguan, Ausayakhun Sakarin, Apivatthakakul Atitaya, Liu Yingna, Snyder Blake M, Margolis Todd P, Keenan Jeremy D
Francis I Proctor Foundation, University of California, San Francisco, California, USA.
Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Ocul Immunol Inflamm. 2024 Jul;32(5):520-524. doi: 10.1080/09273948.2023.2263091. Epub 2023 Oct 6.
Cytomegalovirus (CMV) retinitis can have debilitating impacts on quality of life (QOL), but few contemporary studies have characterized these ramifications. This study assessed the impact of CMV retinitis on vision-related QOL for those living with HIV/AIDS in Thailand.
QOL was assessed as part of a prospective interventional cohort study of patients referred to a tertiary hospital in Thailand for CMV retinitis screening. A validated vision-related QOL questionnaire was administered at the baseline screening visit and at the 6-month study visit. Multivariable linear regression models were performed to determine the effect of CMV retinitis diagnosis on QOL score.
A total of 152 participants completed the QOL questionnaire at their initial clinic visit. At baseline, a diagnosis of CMV retinitis diagnosis was significantly associated with decreased QOL score: unilateral retinitis was associated with a 0.11 (95% CI: -0.26-0.03) decrement in QOL, and bilateral retinitis was associated with a 0.33 (95% CI: -0.51-0.16) decrement (joint P-value = 0.0009). For the 78 participants with a 6-month visit, changes in QOL from baseline were small and not significant. A diagnosis of CMV retinitis was still associated with decreased QOL score at 6 months (joint -value = 0.03).
This study found that vision-related QOL was lower in those with CMV retinitis, especially with bilateral involvement, and did not improve after treatment among those with follow-up. These findings reinforce the debilitating clinical manifestations of this disease, and support efforts for earlier screening to detect CMV retinitis before impacts on QOL have occurred.
巨细胞病毒(CMV)视网膜炎会对生活质量(QOL)产生严重影响,但当代很少有研究对这些影响进行描述。本研究评估了CMV视网膜炎对泰国HIV/AIDS患者视力相关生活质量的影响。
作为一项前瞻性干预队列研究的一部分,对转诊至泰国一家三级医院进行CMV视网膜炎筛查的患者进行了生活质量评估。在基线筛查访视和6个月的研究访视时,使用经过验证的视力相关生活质量问卷。进行多变量线性回归模型以确定CMV视网膜炎诊断对生活质量评分的影响。
共有152名参与者在首次门诊就诊时完成了生活质量问卷。在基线时,CMV视网膜炎诊断与生活质量评分降低显著相关:单侧视网膜炎与生活质量降低0.11(95%CI:-0.26 - 0.03)相关,双侧视网膜炎与生活质量降低0.33(95%CI:-0.51 - 0.16)相关(联合P值 = 0.0009)。对于78名进行了6个月访视的参与者,生活质量从基线的变化很小且不显著。CMV视网膜炎诊断在6个月时仍与生活质量评分降低相关(联合P值 = 0.03)。
本研究发现,CMV视网膜炎患者的视力相关生活质量较低,尤其是双侧受累者,且随访患者治疗后并未改善。这些发现强化了该疾病的严重临床表现,并支持在对生活质量产生影响之前进行早期筛查以检测CMV视网膜炎的努力。