Abstract
The common retinal manifestations of human immunodeficiency virus (HIV) include noninfectious and infectious retinopathy. Antiviral agents have been developed to treat cytomegalovirus (CMV) retinitis, but they are not without complications. The results of treatment of CMV retinitis with foscarnet, ganciclovir, valganciclovir, or cidofovir are encouraging, but systemic toxicity is a problem, as is the development of rhegmatogenous retinal detachment after healing of retinitis. Retinal detachment can often be successfully repaired in cases of CMV retinitis eyes with a good anatomic and visual outcome. Implantation of ganciclovir implants can successfully control retinitis but may be associated with retinal detachment, endophthalmitis, and vitreous hemorrhage. Noninfectious HIV retinopathy, manifested by retinal cotton-wool spots and hemorrhage, is common. The advent of highly active antiretroviral therapy has changed the short-term natural history of opportunistic infections of HIV patients and is associated with an ocular inflammatory syndrome (immune recovery uveitis) in patients with preexisting ocular infections.
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