title: Cystoid macular edema as a result of immune-recovery uveitis.
abstract: BACKGROUND
  Potent antiretroviral therapy can lead to improved immunity in patients with acquired immune deficiency syndrome. However, ocular inflammation can occur in predisposed individuals. This inflammation is referred to as immune-recovery uveitis. Cystoid macular edema (CME) is a complication that can result from this inflammation and is emerging as a major cause of visual loss in human immunodeficiency virus (HIV)-infected patients.
  
  
  METHODS
  A 52-year-old man presented with complaints of intermittent decreased vision that had coincided with the initiation of antiviral treatment. He also reported metamorphopsia and floaters in both eyes of several years duration. He had a history of HIV for 20 years and was only recently started on Highly Active Antiretroviral Therapy (HAART). He reported a vague history of ocular problems involving his retina. Retinal examination revealed bilateral areas of peripheral scarring from presumed past ocular inflammation and thickening and irregularity at each macula. Ancillary testing was performed, and CME was diagnosed.
  
  
  CONCLUSIONS
  Immune-recovery uveitis is a leading cause of visual disturbance in HIV-infected patients with a history of cytomegalovirus (CMV) retinitis on HAART. Although the immune recovery associated with the advent of HAART has decreased the need for potent CMV medications, the heightened immune response can be associated with sight-threatening inflammation.
authors.affiliation: College of Optometry, Nova Southeastern University, Davie, Florida 33328, USA. guzakr@yahoo.com
authors.forename: Richard
authors.initials: R
authors.lastname: Guzak
authors.forename: Julie
authors.initials: J
authors.lastname: Rodman
authors.forename: Joseph
authors.initials: J
authors.lastname: Pizzimenti
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000276:immunology*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D005654:Fundus Oculi; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000139:chemically induced* / Q000150:complications*; D008269:Macular Edema / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D041623:Tomography, Optical Coherence; D014605:Uveitis / Q000209:etiology*; D014786:Vision Disorders / Q000209:etiology