Cytomegalovirus retinitis associated with acquired immunodeficiency syndrome

Abstract

Objective To investigate the fundus characteristics and therapeutic outcomes of cytomegalovirus retinitis (CMVR) associated with acquired immunodeficiency syndrome (AIDS).Methods Thirty-four patients (49 eyes) with AIDS and CMVR were included in the study from department of Ophthalmology,Zhengzhou Second Renmin Hospital during 2003-2010.Visual acuity,slit lamp ophthalmoscopy,indirect ophthalmoscope,fundus photography,fundus fluorescence angiography (FFA),CD4+T-lymphocyte counts,CMV antibody were measured.Intravitreal injection of ganciclovir was performed in 16 patients (24 eyes).The follow-up time was 6-12months.Results Visual acuity of the patients was as following:＜0.1,34 eyes; 0.1-0.5,11 eyes; ＞0.5,4 eyes.Representative CMVR was characterized by full thickness,yellow-white,confluent granular retinal necrosis with hemorrhage,vessel sclerotic and attenuated in 29 eyes.FFA showed fluorescein leakage in late phase.Unrepresentative CMVR was demonstrated in 12 eyes,recognized as granular retinal necrosis located in peripheral retina.Hemorrhage and effusion was not obvious.Pre-retina membrane was found in 4 eyes and retinal detachment in 4 eyes.After intravitreal injection of ganciclovir,visual acuity was improved,fundus lesions shrinked and hemorrhage was absorbed in 13 eyes.Conclusions CMVR has a distinctive manifestation with thickness,yellow-white retinal lesions,hemorrhage and retinal vasculitis.Intravitreal injection of ganciclovir is therapeutic for CMVR. Key words: Acquired immune deficiency syndrome; Cytomegalovirus retinitis; Fundus fluorescence angiography; Ganciclovir