Advances in the diagnosis and management of AIDS-related eye disease

AIDS-related eye disease is changing rapidly. New clinical entities have been reported, most numerous of which are the uveitis syndromes in patients with elevated CD4+ counts. Advances in management of cytomegalovirus retinitis (CMVR) include laser demarcation as an alternative to vitrectomy with silicone oil injection in macula-sparing cytomegalovirus-related retinal detachments and discontinuation of maintenance therapy in select patients with quiescent CMVR and elevated CD4+ counts. Screening guidelines have been proposed for childhood CMVR. Serial fundus photography has been recommended to improve follow-up evaluation of CMVR. A method to improve intraocular lens calculation in silicone-filled eyes has been offered. The rapidity and extent to which drug resistant cytomegalovirus infection develops has been elucidated. And the controversy of oral ganciclovir prophylaxis for cytomegalovirus disease has been argued from several angles. The following article reviews these and other advances in the understanding of AIDS-related eye disease.