Characteristics of fundus lesions in 71 cases of AIDS patients complicated with cytomegalovirus retinitis

Abstract

Objective To investigate the fundus manifestations and risk factors of acquired immunodeficiency syndrome (AIDS) complicated with cytomegalovirus retinitis (CMVR). Methods The clinical data of 71 cases (110 eyes) of CMVR in the Sixth People’s Hospital of Zhengzhou from January 2015 to November 2017 were retrospectively analyzed. The characteristics of fundus and CD4+ T lymphocyte count at onset were emphatically analyzed. Results Thirty-two eyes with retinopathy had early-stage cotton-wool spot in posterior pole with or without hemorrhage; 39 eyes with yellow-white large-patch retinopathy and peripheral granular retinopathy with retinal hemorrhage; 17 eyes were wedge-shaped, arcuate yellowish-white retinopathy with hemorrhage along blood vessels; 11 eyes were optic papilla congestion edema with retinopathy and hemorrhage; 7 eyes had advanced retinal necrosis, atrophy, scar formation, vascular sclerosis and occlusion. CD4+ T cell count ranged from 1-144/mm3, and 59 cases were below 50/mm3. Seventy CMVR patients were CMV-DNA(+ ). Conclusions Cotton-wool spot with or without bleeding in posterior is the main characteristics of CMVR. The main characters of progressive stage are yellow-white large-patch retinopathy and granulate retinopathy with bleeding, wedge-shaped and arcuate retinopathy with hemorrhage along the blood vessels, congestion and edema of optic papilla with retinopathy and bleeding. CD4+ T cell count below 100/mm3 will lead to CMVR. Key words: Cytomegalovirus retinitis; Acquired immunodeficiency syndrome; CD4+ T cell