title: Bilateral ischemic maculopathy in acquired immune deficiency syndrome.
abstract: BACKGROUND
  This brief report aims to report a case of bilateral macular ischemia as a cause of sudden decreased vision in a patient with acquired immune deficiency syndrome (AIDS).
  
  
  RESULTS
  A 26-year-old male with disseminated cryptococcal meningitis, Candida thrush, Pneumocystis jiroveci pneumonia, and positive human immunodeficiency virus (HIV) infection with CD4 count of 4 cells/μl complained of sudden blurred vision in both eyes while on treatment with systemic antiviral, antifungal, and antibiotic medications. Ocular examination revealed HIV retinopathy changes with significant macular ischemia in both eyes, which was confirmed by fluorescein angiography. One dose of intravitreal foscarnet (1.2 mg/0.1 cc) was injected in both eyes. Laboratory work-up of serum and vitreous samples showed negative cytomegalovirus (CMV) titers. At 2 weeks of follow-up, he was started on treatment with atripla, a combination anti-retroviral therapy for AIDS. At 6 weeks of follow-up, there was an improvement in visual acuity and clinical findings.
  
  
  CONCLUSIONS
  Noninfectious HIV retinopathy in AIDS is common, but bilateral macular ischemia is a rare presentation. It is important to rule out CMV retinitis as it is a major cause of visual morbidity among AIDS patients.
authors.affiliation: Associated Retina Consultants Ltd, 7600 N 15th Street, Suite #155, Phoenix, AZ, 85020, USA. keen_268@yahoo.com.
authors.forename: Kiran
authors.initials: K
authors.lastname: Turaka
authors.forename: Rahul
authors.initials: R
authors.lastname: Reddy
authors.forename: Ashkahn
authors.initials: A
authors.lastname: Golshani
authors.forename: Wong Yu
authors.initials: WY
authors.lastname: Khaw
authors.forename: J Shepard
authors.initials: JS
authors.lastname: Bryan