[Cytomegalovirus retinitis associated with Acquired immunodeficiency syndrome]

To investigate the fundus characteristics, systemic features and therapeutic outcomes of cytomegalovirus (CMV) retinitis associated with acquired immunodeficiency syndrome (AIDS).

Fundus features, visual acuity, fundus fluorescence angiography (FFA) and CD4(+)T-lymphocyte counts of 15 eyes (8 patients) of CMV retinitis associated with AIDS were analyzed. The time of average follow-up was 16 months. Intravitreal injection of ganciclovir (400 microg) was performed in 4 eyes (2 patients).

In the initial examination, visual acuity of the patients was as following: < or = 0.2, 10 eyes (66.7%); no light perception (NLP) (2 eyes); light perception (LP) (2 eyes); 0.04-0.2, 6 eyes; > or = 1.0, 3 eyes (20.0%) and 0.8 or 0.9 each for 1 eye (13.3%). The fundus manifestation includes: the retinal vasculitis; dense, full-thickness, yellow-white lesions along vascular distribution, and hemorrhage on the retinal surface; granular with irregular border featured as "cheese and ketchup retinitis" was revealed in 12 eyes; the vitreous was clear or light opaque. Late stage of the retinopathy was demonstrated in 2 eyes characterized as grayish atrophic retina, vessel-sclerotic and attenuated, retinal pigment epithelium (RPE) atrophy, prominent choroid vasculature, and optic nerve atrophy. Retinal detachment was found in 1 eye. CD4(+)T-lymphocytes counts in peripheral blood were between 0 approximately 36/mm(3), average (15.0 +/- 12.9) mm(3). Visual acuity improved, fundus lesions disappeared observably and hemorrhage was absorbed in the 4 eyes after intravitreal injection of ganciclovir.

CMV retinitis is the severest and the most common intraocular complication in patients with AIDS. For the patients with yellow-white retinal lesions, hemorrhage and retinal vasculitis of undefined cause, the antibody of serum anti-human immunodeficiency virus (HIV) should be screened. Routing eye examination should be performed if the serological test of HIV is positive.