Retrospective study of cytomegalovirus retinitis complicated with acquired immunodeficiency syndrome

This study was designed to explore the characteristics and therapy of cytomegalovirus retinitis (CR) in patients diagnosed with acquired immunodeficiency syndrome (AIDS).

A total of 67 AIDS patients (78 eyes) with CR findings of were collected from January 2009 to January 2013. The correlation between CR, cellular immunity, risk factor, clinical characteristics, treatment and prognosis of CR was assessed. The incidence of CR in different CD4+T lymphocyte count groups was analyzed.

Among all participants, 58 were male and 9 females, aged from 18-60 years, (38±9) years on average. CD4+ T lymphocyte count of CR patients ranged from 0-141 cells/µl and < 50 cells/µl in 81.3% of cases. CR was the primary manifestation in 10.2%, retinal lesions in 25.1%, best corrected visual acuity (BCVA) < 0.3 in 54% of AIDS patients. Retinal necrosis was involved near the posterior pole in 62.5% of CR patients. The visual acuity of 60 (47.6%) eyes was improved after treatment and 94.1% cases were cured within 3 months. Anti-CMV treatments including induction and maintenance of ganciclovir or foscarnet were discontinued when CD4+T lymphocyte count was > 150 cells/µl for three consecutive months. Complicated cataract, retinal detachment and immune reconstitution uveitis were observed in 20.5%, 12.1% and 13.1% of cases, respectively.

Decreased CD4+T lymphocyte count is a risk factor for CR. HAART and anti-CMV therapy are efficacious treatment of CR. Conventional eye examinations should be conducted to early diagnose CR or other opportunistic infections in all AIDS patients.