The spectrum of eye disease in children with AIDS due to vertically transmitted HIV disease: clinical findings, virology and recommendations for surveillance.

Abstract

Eye disease in children infected with HIV is uncommon, but there is little information on which children require screening or surveillance and the management of those with retinitis. We examined 12 children with symptomatic HIV disease (of a cohort of 98 HIV-positive children) using indirect ophthalmoscopy. When retinitis was found it was documented photographically at the time of diagnosis and on follow-up. Four cases of infective retinitis were diagnosed: three with probable cytomegalovirus retinitis and one with progressive outer retinal necrosis. Detection of reactivation is difficult and we recommend fundus photography under general anaesthesia wherever possible. Children with other end-organ disease, symptomatic eye disease and advanced HIV disease with severe immunosuppression require ophthalmological surveillance.