Retinochoroiditis in the acquired immune deficiency syndrome. Findings in consecutive post-mortem examinations

A number of opportunistic agents may cause retinitis or retinochoroiditis in patients with the acquired immunodeficiency syndrome. Minimal consecutive data is available on the histopathologically confirmed prevalence of these ocular infections. A total of 48 consecutive patients with acquired immunodeficiency syndrome-related death underwent autopsy and had their eyes submitted for histopathological examination. Conventional light microscopy combined with immunohistochemistry revealed cytomegalovirus retinitis in 15 patients, toxoplasma gonddi retinochoroiditis in 3 patients and mycobacterial choroiditis in one individual with some infections being coexistent. Clinical examination prior to death was highly accurate in detecting cytomegalovirus retinitis, but failed to determine all non-cytomegalovirus causes of retinochoroiditis. Ten of 15 patients with cytomegalovirus retinitis had associated non-cular cytomegalovirus infections, most often in the brain and adrenals. After clinical detection of cytomegalovirus retinitis the median survival time was 5.5 months, not adversely affected by additional non-ocular cytomegalovirus infection.