Retinal findings and characteristics in AIDS patients with systemic Mycobacterium avium-intracellulare complex and toxoplasmic encephalitis.
OBJECTIVE
The purpose of this study was to evaluate the incidence and characteristics of retinal and choroidal manifestations of toxoplasmosis and/or Mycobacterium avium-intracellulare complex (MAC) in patients with acquired immunodeficiency syndrome (AIDS).


METHODS
The authors analyzed their prospectively collected data and found 120 patients with new retinal lesions (group A) that were diagnosed 3 months or longer following the diagnosis of MAC and/or toxoplasmic encephalitis. The authors also performed a point prevalence study of retinal/choroidal findings in 25 consecutive AIDS patients (group B) without known eye disease who had been recently treated for toxoplasmic encephalitis and/or disseminated MAC infections. In addition, the characteristics of retinochoroidal toxoplasmosis scars in 5 AIDS patients were studied and compared with the characteristics of scars in 18 immunocompetent patients.


RESULTS
In this study the incidence of ocular manifestations of MAC was zero (95% confidence interval [CI] 0.0% to 3.8%). Two of 25 patients (8%) (95% CI 1% to 26%) in group A and 2 of 11 patients (18.1%) (95% CI 3.3% to 51.8%) in group B had toxoplasmic retinochoroiditis.


CONCLUSIONS
In AIDS patients, ocular manifestations of toxoplasmosis are more common than ocular MAC. In addition, when compared with immunocompetent patients, AIDS patients tend to have retinochoroidal scars with less retinal pigment epithelium hyperplasia (1.8+ vs 3+) (P = .03).
Arevalo
J F
JF
Department of Ophthalmology, Shiley Eye Center, La Jolia, CA 92093-0946, USA.
Quiceno
J I
JI
García
R F
RF
McCutchan
J A
JA
Munguia
D
D
Nelson
J A
JA
Freeman
W R
WR
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D016470:Bacteremia / Q000150:complications*; D002140:California / Q000453:epidemiology; D015862:Choroid Diseases / Q000453:epidemiology / Q000382:microbiology / Q000469:parasitology; D004660:Encephalitis / Q000469:parasitology*; D015818:Eye Infections, Bacterial / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications*; D015995:Prevalence; D011446:Prospective Studies; D012164:Retinal Diseases / Q000453:epidemiology / Q000382:microbiology / Q000469:parasitology*; D016781:Toxoplasmosis, Cerebral / Q000150:complications*; D014126:Toxoplasmosis, Ocular / Q000453:epidemiology / Q000209:etiology*