Protocol for Grading Cytomegalovirus (CMV) Retinitis from Fundus Photographs.Studies of the Ocular Complications of AIDS (SOCA) Research Group

摘要

The Studies of the Ocular Complications of AIDS (SOCA) Research Group developed aprotocol for assessment of cytomegalovirus (CMV) retinitis and other abnormalities from fundus photographs. Using wide-angle cameras, standardized fundus photography is performed to document the post-equatorial fundus in a set of color slides. For each eye, the array of nine photographic fields (a non-simultaneous stereoscopic slide pair of the posterior pole of a retina surrounded by eight slightly-overlapping non-stereoscopic slides) is mounted in a plastic sheet and examined with a 5X magnifying viewer. The principal abnormalities evaluated are the white retinal opacities typical of active CMV retinitis and the subsequent retinal atrophy (usually accompanied by pigment abnormalities). Chief goals of the grading protocol are: (1) to evaluate features of CMV retinitis, such as presence of lesions, their location, and stage of border activity; (2) to assess progression (either movement of existing lesions or appearance of new ones) of retinitis lesions between visits; and (3) to estimate the area of retina involved by retinitis via imposition of a grid, so that change in area can be calculated over time.