[Cytomegalovirus retinitis associated with Acquired immunodeficiency syndrome].
OBJECTIVE
To investigate the fundus characteristics, systemic features and therapeutic outcomes of cytomegalovirus (CMV) retinitis associated with acquired immunodeficiency syndrome (AIDS).


METHODS
Fundus features, visual acuity, fundus fluorescence angiography (FFA) and CD4(+)T-lymphocyte counts of 15 eyes (8 patients) of CMV retinitis associated with AIDS were analyzed. The time of average follow-up was 16 months. Intravitreal injection of ganciclovir (400 microg) was performed in 4 eyes (2 patients).


RESULTS
In the initial examination, visual acuity of the patients was as following: < or = 0.2, 10 eyes (66.7%); no light perception (NLP) (2 eyes); light perception (LP) (2 eyes); 0.04-0.2, 6 eyes; > or = 1.0, 3 eyes (20.0%) and 0.8 or 0.9 each for 1 eye (13.3%). The fundus manifestation includes: the retinal vasculitis; dense, full-thickness, yellow-white lesions along vascular distribution, and hemorrhage on the retinal surface; granular with irregular border featured as "cheese and ketchup retinitis" was revealed in 12 eyes; the vitreous was clear or light opaque. Late stage of the retinopathy was demonstrated in 2 eyes characterized as grayish atrophic retina, vessel-sclerotic and attenuated, retinal pigment epithelium (RPE) atrophy, prominent choroid vasculature, and optic nerve atrophy. Retinal detachment was found in 1 eye. CD4(+)T-lymphocytes counts in peripheral blood were between 0 approximately 36/mm(3), average (15.0 +/- 12.9) mm(3). Visual acuity improved, fundus lesions disappeared observably and hemorrhage was absorbed in the 4 eyes after intravitreal injection of ganciclovir.


CONCLUSIONS
CMV retinitis is the severest and the most common intraocular complication in patients with AIDS. For the patients with yellow-white retinal lesions, hemorrhage and retinal vasculitis of undefined cause, the antibody of serum anti-human immunodeficiency virus (HIV) should be screened. Routing eye examination should be performed if the serological test of HIV is positive.
Ye
Jun-jie
JJ
Department of Ophthalmology, Peking Union Medical College Hospital, Eye Research Center of Chinese Academy of Medical Sciences, Beijing 100730, China. yejunjie@hotmail.com
Li
Hai-yan
HY
Sun
Ding
D
Min
Han-yi
HY
Han
Bao-ling
BL
Hu
Tian-sheng
TS
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000175:diagnosis*; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D017726:Cytomegalovirus Retinitis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000187:drug effects / Q000503:physiopathology / Q000821:virology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects
D000998:Antiviral Agents; D015774:Ganciclovir