title: Unilateral Ischemic Maculopathy Associated with Cytomegalovirus Retinitis in Patients with AIDS: Optical Coherence Tomography Findings.
abstract: To describe the clinical and optical coherence tomography (OCT) characteristics of ischemic maculopathy in two patients with acquired immunodeficiency syndrome (AIDS). Two patients with AIDS and cytomegalovirus (CMV) retinitis developed ischemic maculopathy. Both patients presented with central visual loss and active granular CMV retinitis. The presence of opacification of the superficial retina in the macular area and intraretinal edema suggested the diagnosis. Fluorescein angiography changes were similar in the two cases with enlargement of the foveal avascular zone and late staining of juxtafoveal vessels. OCT changes were suggestive of retinal ischemia: Increased reflectivity from the inner retinal layer and decreased backscattering from the retinal photoreceptors due to fluid and retinal edema. Ischemic maculopathy may cause a severe and permanent decrease in vision in AIDS patients. Fluorescein angiography and OCT should be considered in any patient with AIDS and unexplained visual loss. The mechanism of ischemic maculopathy may be multifactorial.
authors.affiliation: Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: J Fernando
authors.initials: JF
authors.lastname: Arevalo
authors.affiliation: Department of Retina and Vitreous, Ophthalmology Clinic El Viñedo, Valencia, Venezuela.
authors.forename: Reinaldo A
authors.initials: RA
authors.lastname: Garcia
authors.affiliation: Department of Retina and Vitreous, Ophthalmology Clinic Centro Caracas, Caracas, Venezuela.
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Arevalo
authors.affiliation: Department of Retina and Vitreous, Ophthalmology Clinic Oftalmolaser, Lima, Peru.
authors.forename: Carlos F
authors.initials: CF
authors.lastname: Fernandez
keywords: Acquired Immunodeficiency Syndrome; Cytomegalovirus Retinitis; Foveal Avascular Zone; Optical Coherence Tomography; Unilateral Ischemic Maculopathy