CMV retinitis screening and treatment in a resource-poor setting: three-year experience from a primary care HIV/AIDS programme in Myanmar
Kyaw, Moe Kyaw
Drew, W Lawrence
AffiliationMedical Action Myanmar, Yangon, Myanmar; Wills Eye Institute, Retina Service, Philadelphia, PA, USA; Médecins Sans Frontières OCA, Yangon, Myanmar; Médecins Sans Frontières, London, UK; Centre for Infectious Disease Epidemiology and Research, University of Cape Town, South Africa; University of California San Francisco, San Francisco, CA, USA; Kilimanjaro Centre for Community Ophthalmology, Moishe, Tanzania; California Pacific Medical Center, San Francisco, CA, USA; Seva Foundation, Berkeley, CA, USA.
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AbstractCytomegalovirus 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 <100 cells/mm3) by AIDS clinicians using indirect ophthalmoscopy, and treatment of all patients with active retinitis by intravitreal injection of ganciclovir. Prior to this programme, CMV retinitis was not routinely examined for, or treated, in Myanmar.