Cytomegalovirus retinitis associated with acquired immunodeficiency syndrome

• Published in: Chinese medical journal Vol. 124; no. 8; pp. 1134 - 1138
• Main Authors: Geng, Shuang, Ye, Jun-jie, Zhao, Jia-liang, Li, Tai-sheng, Han, Yang
• Format: Journal Article
• Language: English
• Published: China Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China%Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China 01.04.2011
• Subjects: Acquired Immunodeficiency Syndrome - complications; Acquired Immunodeficiency Syndrome - immunology; Acquired Immunodeficiency Syndrome - metabolism; Adult; Antiviral Agents - pharmacology; CD4-Positive T-Lymphocytes - metabolism; Cytomegalovirus Retinitis - drug therapy; Cytomegalovirus Retinitis - etiology; Cytomegalovirus Retinitis - immunology; Cytomegalovirus Retinitis - metabolism; Female; Fluorescein Angiography; Ganciclovir - pharmacology; Humans; Male; Middle Aged; Retrospective Studies; T淋巴细胞; Young Adult; 人类免疫缺陷病毒; 巨细胞病毒; 病毒性; 眼底病变; 综合症; 血管造影; 视网膜; cytomegalovirus retinitis; ganciclovir; acquired immunodeficiency syndrome
• ISSN: 0366-6999; 2542-5641
• DOI: 10.3760/cma.j.issn.0366-6999.2011.08.003

Background Cytomegalovirus （CMV） retinitis is the most severe intraocular complication that results in total retinal destruction and loss of visual acuity in patients with acquired immunodeficiency syndrome （AIDS）. This study aimed to investigate the fundus characteristics, systemic manifestations and therapeutic outcomes of CMV retinitis associated with AIDS.Methods It was a retrospective case series. CMV retinitis was present in 39 eyes （25 patients）. Best corrected visual acuities, anterior segment, fundus features, fundus fluorescence angiography （FFA） and CD4＋ T-lymphocyte counts of the patients with CMV retinitis associated with AIDS were analyzed. Intravitreal injections of ganciclovir （400 μg） were performed in 4 eyes （2 patients）.Results Retinal vasculitis, dense, full-thickness, yellow-white lesions along vascular distribution with irregular granules at the border, and hemorrhage on the retinal surface were present in 28 eyes. The vitreous was clear or mildly opaque.Late stage of the retinopathy was demonstrated in 8 eyes characterized as atrophic retina, sclerotic and attenuated vessels, retinal pigment epithelium （RPE） atrophy, and optic nerve atrophy. Retinal detachment was found in 3 eyes. The average CD4＋ T-lymphocyte count in peripheral blood of the patients with CMV retinitis was （30.6±25.3） ×106/L （range,（0-85） × 106/L）. After intravitreal injections of ganciclovir, visual acuity was improved and fundus lesions regressed.Conclusions CMV retinitis is the most severe and the most common intraocular complication in patients with AIDS. For the patients with yellow-white retinal lesions, hemorrhage and retinal vasculitis without clear cause, human immunodeficiency virus （HIV） serology should be performed. Routine eye examination is also indicated in HIV positive patients.