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The Uveitis Atlas pp 1–10Cite as

HIV Manifestations of Posterior Segment

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Abstract

The introduction of highly active antiretroviral therapy (HAART) has significantly reduced the incidence and prevalence of HIV-related ocular morbidity. Still, cytomegalovirus (CMV) retinitis is considered the major cause of visual loss in HIV-infected individuals. Timely suspicion and prompt comprehensive evaluation is essential to reach a clinical diagnosis and initiate the required treatment. Taking into consideration other infrequent pathologies that may affect immunocompromised individuals, and management of emerging drug resistance and complications, may improve the final visual outcome.

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  • Abu El-Asrar AM, Abouammoh M, Al-Mezaine HS. Tuberculous Uvieitis. Int Ophthalmol. 2010;50(2):19–39.

    Article  Google Scholar 

  • Akler ME, Johnson DW, Burman WJ, Johnson SC. Anterior uveitis and hypotony after intravenous cidofovir for the treatment of cytomegalovirus retinitis. Ophthalmology. 1998;105:651–7.

    Article  CAS  PubMed  Google Scholar 

  • Althaus C, Loeffler KU, Schimkat M, Hudde T, Sundmacher R. Prophylactic argon laser coagulation for rhegmatogenous retinal detachment in AIDS patients with cytomegalovirus retinitis. Graefes Arch Clin Exp Ophthalmol. 1998;236:359–64.

    Article  CAS  PubMed  Google Scholar 

  • Amaratunge BC, Camuglia JE, Hall AJ. Syphilitic uveitis: a review of clinical manifestations and treatment outcomes of syphilitic uveitis in human immunodeficiency virus-positive and negative patients. Clin Exp Ophthalmol. 2010;38(1):68–74.

    Article  PubMed  Google Scholar 

  • Arevalo JF, Fuenmayor-Rivera D, Giral AE, Murcia E. Indocyanine green videoangiography of multifocal Cryptococcus neoformans choroiditis in a patient with acquired immunodeficiency syndrome. Retina. 2001;21(5):537–41.

    Article  CAS  PubMed  Google Scholar 

  • Auer C, Herbort CP. Indocyanine green angiographic features in posterior scleritis. Am J Ophthalmol. 1998;126:471–6.

    Article  CAS  PubMed  Google Scholar 

  • Auer C, Bernasconi O, Herbort CP. Toxoplasmic retinochoroiditis: new insights provided by indocyanine green angiography. Am J Ophthalmol. 1997;123:131–3.

    Article  CAS  PubMed  Google Scholar 

  • Bacigalupo A, et al. Combined foscarnet-ganciclovir treatment for cytomegalovirus infections after allogeneic hemopoietic stem cell transplantation. Transplantation. 1996;62:376–80.

    Article  CAS  PubMed  Google Scholar 

  • Barrett L, Walmsley S. CMV retinopathy in the antiretroviral therapy era: prevention, diagnosis, and management. Curr Infect Dis Rep. 2012;14:435–44.

    Article  PubMed  Google Scholar 

  • Bate SL, Dollard SC, Cannon MJ. Cytomegalovirus seroprevalence in the United States: the national health and nutrition examination surveys, 1988-2004. Clinical Infect Dis. 2010;50:1439–47.

    Article  Google Scholar 

  • Bernasconi O, Auer C, Zografos L, Herbort CP. Indocyanine green angiographic findings in sympathetic ophthalmia. Graefes Arch Clin Exp Ophthalmol. 1998;236:635–8.

    Article  CAS  PubMed  Google Scholar 

  • Biswas J, Choudhry S, Priya K, Gopal L. Detection of cytomegalovirus from vitreous humor in a patient with progressive outer retinal necrosis. Indian J Ophthalmol. 2002;50:319–21.

    PubMed  Google Scholar 

  • Bowen EF, Griffiths PD, Davey CC, Emery VC, Johnson MA. Lessons from the natural history of cytomegalovirus. AIDS. 1996;10 Suppl 1:S37–41.

    PubMed  Google Scholar 

  • Canzano JC, Reed JB, Morse LS. Vitreomacular traction syndrome following highly active antiretroviral therapy in AIDS patients with cytomegalovirus retinitis. Retina. 1998;18:443–7.

    Article  CAS  PubMed  Google Scholar 

  • Carney MD, Combs JL, Waschler W. Cryptococcal choroiditis. Retina. 1990;10:27–32.

    Article  CAS  PubMed  Google Scholar 

  • Dave VP, Mathai A, Pappuru RR. Results of silicone oil removal in post-cytomegalovirus retinitis-related retinal detachment. J Ophthalmic Inflamm Infect. 2012;2:153–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • David SB, et al. Safety of intravitreous fomivirsen for treatment of cytomegalovirus retinitis in patients with AIDS. Am J Ophthalmol. 2002;133:484–98.

    Google Scholar 

  • Douglas J, et al. Mortality in patients with the acquired immunodeficiency syndrome treated with either foscarnet or ganciclovir for cytomegalovirus retinitis. Studies of Ocular Complications of AIDS Research Group, in collaboration with the AIDS Clinical Trials Group. New Engl J Med. 1992; 326:213–20.

    Google Scholar 

  • Engstrom RE, et al. The progressive outer retinal necrosis syndrome. A variant of necrotizing herpetic retinopathy in patients with AIDS. Ophthalmology. 1994;101:1488–502.

    Article  PubMed  Google Scholar 

  • Espinoza JV, Lasave AF, Guzman-Blanco M, Arevalo FA, Arevalo JF. Disseminated histoplasmic multifocal choroiditis in AIDS. Ophth Surg Lasers Imaging Retina. 2014;45(2):179–80. doi:10.3928/23258160-20140131-02. Epub 2014 Feb 7.

    Article  Google Scholar 

  • Feinberg JE, et al. A randomized, double-blind trial of valaciclovir prophylaxis for cytomegalovirus disease in patients with advanced human immunodeficiency virus infection. AIDS Clinical Trials Group Protocol 204/Glaxo Wellcome 123-014 International CMV Prophylaxis Study G. J Infect Dis. 1998;177:48–56.

    Article  CAS  PubMed  Google Scholar 

  • Forster DJ, Dugel PU, Frangieh GT, Liggett PE, Rao NA. Rapidly progressive outer retinal necrosis in the acquired immunodeficiency syndrome. Am J Ophthalmol. 1990;110:341–8.

    Article  CAS  PubMed  Google Scholar 

  • Foscarnet-Ganciclovir Cytomegalovirus Retinitis Trial: 5. Clinical features of cytomegalovirus retinitis at diagnosis. Studies of ocular complications of AIDS Research Group in collaboration with the AIDS Clinical Trials Group. Am J Ophthalmol. 1997; 124:141–57.

    Google Scholar 

  • Freeman WR, et al. Risk factors for development of rhegmatogenous retinal detachment in patients with cytomegalovirus retinitis. Am J Ophthalmol. 1993;116:713–20.

    Article  CAS  PubMed  Google Scholar 

  • Friedlander SM, et al. Optic neuropathy preceding acute retinal necrosis in acquired immunodeficiency syndrome. Arch Ophthalmol. 1996;114:1481–5.

    Article  CAS  PubMed  Google Scholar 

  • Hatton MP, Duker JS, Reichel E, Morley MG, Puliafito CA. Treatment of relapsed cytomegalovirus retinitis with the sustained-release ganciclovir implant. Retina. 1998;18:50–5.

    Article  CAS  PubMed  Google Scholar 

  • Hodge WG, et al. Clinical risk factors for cytomegalovirus retinitis in patients with AIDS. Ophthalmology. 2004;111:1326–33.

    Article  PubMed  Google Scholar 

  • Holbrook JT, et al. Evaluation of the United States public health service guidelines for discontinuation of anticytomegalovirus therapy after immune recovery in patients with cytomegalovirus retinitis. Am J Ophthalmol. 2011;152:628–37.e1.

    Article  PubMed  PubMed Central  Google Scholar 

  • Holland GN. The progressive outer retinal necrosis syndrome. Int Ophthalmol. 1994;18:163–5.

    Article  CAS  PubMed  Google Scholar 

  • Holland GN, Shuler JD. Progression rates of cytomegalovirus retinopathy in ganciclovir-treated and untreated patients. Arch Ophthalmol. 1992;110:1435–42.

    Article  CAS  PubMed  Google Scholar 

  • Holland GN, Buhles WC, Mastre B, Kaplan HJ. A controlled retrospective study of ganciclovir treatment for cytomegalovirus retinopathy. Use of a standardized system for the assessment of disease outcome UCLA CMV Retinopathy Study Group. Arch Ophthalmol. 1989;107:1759–66.

    Article  CAS  PubMed  Google Scholar 

  • Hoover DR, et al. Occurrence of cytomegalovirus retinitis after human immunodeficiency virus immunosuppression. Arch Ophthalmol. 1996;114:821–7.

    Article  CAS  PubMed  Google Scholar 

  • Irvine AR, et al. Retinal detachment in AIDS: long-term results after repair with silicone oil. Br J Ophthalmol. 1997;81:180–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Jabs DA, et al. Risk factors for mortality in patients with AIDS in the era of highly active antiretroviral therapy. Ophthalmology. 2005;112:771–9.

    Article  PubMed  Google Scholar 

  • Jabs DA, Ahuja A, Van Natta M, Dunn JP, Yeh S. Comparison of treatment regimens for cytomegalovirus retinitis in patients with aids in the era of highly active antiretroviral therapy. Ophthalmology. 2013;120(6):1262–70. doi:10.1016/j.ophtha.2012.11.023.

    Article  PubMed  PubMed Central  Google Scholar 

  • Karavellas MP, Song M, Macdonald JC, Freeman WR. Long-term posterior and anterior segment complications of immune recovery uveitis associated with cytomegalovirus retinitis. Am J Ophthalmol. 2000;130:57–64.

    Article  CAS  PubMed  Google Scholar 

  • Kashiwase M, et al. Progressive outer retinal necrosis caused by herpes simplex virus type 1 in a patient with acquired immunodeficiency syndrome. Ophthalmology. 2000;107:790–4.

    Article  CAS  PubMed  Google Scholar 

  • Kedhar SR, Jabs DA. Cytomegalovirus retinitis in the era of highly active antiretroviral therapy. Herpes. 2007;14:66–71.

    PubMed  Google Scholar 

  • Kirsch LS, et al. Intravitreal cidofovir (HPMPC) treatment of cytomegalovirus retinitis in patients with acquired immune deficiency syndrome. Ophthalmology. 1995;102:533–42; discussion 542–3.

    Article  CAS  PubMed  Google Scholar 

  • Kuppermann BD, Holland GN. Immune recovery uveitis. Am J Ophthalmol. 2000;130:103–6.

    Article  CAS  PubMed  Google Scholar 

  • Lalezari J, et al. A safety study of oral valganciclovir maintenance treatment of cytomegalovirus retinitis. J Acquire Immune Defic Syndrom. 2002;30:392–400.

    Article  CAS  Google Scholar 

  • Mansour AM. Cytomegalovirus optic neuritis. Curr Opin Ophthalmol. 1997;8:55–8.

    Article  CAS  PubMed  Google Scholar 

  • Margolis TP, et al. Varicella-zoster virus retinitis in patients with the acquired immunodeficiency syndrome. Am J Ophthalmol. 1991;112:119–31.

    Article  CAS  PubMed  Google Scholar 

  • Martin DF, et al. A controlled trial of valganciclovir as induction therapy for cytomegalovirus retinitis. N Engl J Med. 2002;346:1119–26.

    Article  CAS  PubMed  Google Scholar 

  • Meffert SA, Kertes PJ, Lim PL, Conway MD, Peyman GA. Successful treatment of progressive outer retinal necrosis using high-dose intravitreal ganciclovir. Retina. 1997;17:560–2.

    Article  CAS  PubMed  Google Scholar 

  • Moorthy RS, et al. Management of varicella zoster virus retinitis in AIDS. Br J Ophthalmol. 1997;81:189–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Morrison VL, et al. Intravitreal triamcinolone acetonide for the treatment of immune recovery uveitis macular edema. Ophthalmology. 2007;114:334–39.

    Article  PubMed  Google Scholar 

  • Nussenblatt RB, Lane HC. Human immunodeficiency virus disease: changing patterns of intraocular inflammation. Am J Ophthalmol. 1998;125:374–82.

    Article  CAS  PubMed  Google Scholar 

  • Ohta H, et al. Foscarnet therapy for ganciclovir-resistant cytomegalovirus retinitis after stem cell transplantation: effective monitoring of CMV infection by quantitative analysis of CMV mRNA. Bone Marrow Transplant. 2001;27:1141–5.

    Article  CAS  PubMed  Google Scholar 

  • Oshima Y, Harino S, Hara Y, Tano Y. Indocyanine green angiographic findings in Vogt-Koyanagy-Harada disease. Am J Ophthalmol. 1996;122:58–66.

    Article  CAS  PubMed  Google Scholar 

  • Patel A, Olavarria E. Optic neuritis preceding progressive outer retinal necrosis in an immunocompromised patient after allogeneic stem cell transplantation. Ann Hematol. 2013;92(10):1427–9.

    Article  PubMed  Google Scholar 

  • Patel SS, et al. Cytomegalovirus papillitis in patients with acquired immune deficiency syndrome. Visual prognosis of patients treated with ganciclovir and/or foscarnet. Ophthalmology. 1996;103:1476–82.

    Article  CAS  PubMed  Google Scholar 

  • Pérez-Blázquez E, Traspas R, Méndez Marín I, Montero M. Intravitreal ganciclovir treatment in progressive outer retinal necrosis. Am J Ophthalmol. 1997;124:418–21.

    Article  PubMed  Google Scholar 

  • Richard AL, et al. Morbidity and toxic effects associated with ganciclovir or foscarnet therapy in a randomized cytomegalovirus retinitis trial. Studies of ocular complications of AIDS Research Group, in collaboration with the AIDS Clinical Trials Group. Archiv Int Med. 1995;155:65–74.

    Google Scholar 

  • Rozanova EB, Teplinskaia LE, Kaliberdina AF, Barisani-Asenbauer T. Cytomegalovirus antibodies in tear fluid of patients with retinitis. Arch Virol. 2006;151:2407–17.

    Article  CAS  PubMed  Google Scholar 

  • Saran BR, Pomilla PV. Retinal vascular nonperfusion and retinal neovascularization as a consequence of cytomegalovirus retinitis and cryptococcal choroiditis. Retina. 1996;16:510–2.

    Article  CAS  PubMed  Google Scholar 

  • Scott IU, Luu KM, Davis JL. Intravitreal antivirals in the management of patients with acquired immunodeficiency syndrome with progressive outer retinal necrosis. Arch Ophthalmol. 2002;120:1219–22.

    PubMed  Google Scholar 

  • Segarra-Newnham M, Salazar MI. Valganciclovir: a new oral alternative for cytomegalovirus retinitis in human immunodeficiency virus-seropositive individuals. Pharmacotherapy. 2002;22:1124–8.

    Article  CAS  PubMed  Google Scholar 

  • Spaide RF, Vitale AT, Toth IR, Oliver JM. Frosted branch angiitis associated with cytomegalovirus retinitis. Am J Ophthalmol. 1992;113:522–8.

    Article  CAS  PubMed  Google Scholar 

  • Spector SA, et al. Oral ganciclovir for the prevention of cytomegalovirus disease in persons with AIDS. Roche Cooperative Oral Ganciclovir Study Group. New Engl J Med. 1996;334:1491–7.

    Article  CAS  PubMed  Google Scholar 

  • Stone TW, Jaffe GJ. Reversible bull’s-eye maculopathy associated with intravitreal fomivirsen therapy for cytomegalovirus retinitis. Am J Ophthalmol. 2000;130:242–3.

    Article  CAS  PubMed  Google Scholar 

  • Sugar EA, et al. Incidence of cytomegalovirus retinitis in the era of highly active antiretroviral therapy. Am J Ophthalmol. 2012;153:1016–24.e5.

    Article  PubMed  PubMed Central  Google Scholar 

  • Thorne JE, et al. Incidence of and risk factors for visual acuity loss among patients with AIDS and cytomegalovirus retinitis in the era of highly active antiretroviral therapy. Ophthalmology. 2006;113:1432–40.

    Article  PubMed  Google Scholar 

  • Thorne JE, Van Natta ML, Jabs DA, Duncan JL, Srivastava SK. Visual field loss in patients with cytomegalovirus retinitis. Ophthalmology. 2011;118:895–901.

    Article  PubMed  Google Scholar 

  • Wei LL, Park SS, Skiest DJ. Prevalence of visual symptoms among patients with newly diagnosed cytomegalovirus retinitis. Retina. 2002;22:278–82.

    Article  PubMed  Google Scholar 

  • Wiegand TW, Young LHY. Cytomegalovirus retinitis. Int Ophthalmol Clin. 2006;46:91–110.

    Article  PubMed  Google Scholar 

  • Wolfensberger TJ, Piguet B, Herbort CP. Indocyanine green angiographic features in tuberculous chorioretinitis. Am J Ophthalmol. 1999;127:350–3.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Retina Division, Wilmer Eye Institute, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Maumenee 752, Baltimore, MD, 21287, USA

    J. Fernando Arevalo

  2. Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia

    Marwan A. Abouammoh

  3. National Institute of Infectious Diseases – INI, Oswaldo Cruz Foundation, Fiocruz, Brazil

    André Luiz Land Curi

Authors
  1. J. Fernando Arevalo
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  2. Marwan A. Abouammoh
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  3. André Luiz Land Curi
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Corresponding author

Correspondence to J. Fernando Arevalo .

Editor information

Editors and Affiliations

  1. Advanced Eye Center, PGIMER, Chandigarh, India

    Vishali Gupta

  2. Ophthalmology, University of Nebraska Medical Center, Omaha, Nebraska, USA

    Quan Dong Nguyen

  3. Department of Ophthalmology, Pitié-Salpêtrière University, Paris, France

    Phuc LeHoang

  4. University of Lausanne, Lausanne, Switzerland

    Carl P Herbort Jr.

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Arevalo, J.F., Abouammoh, M.A., Curi, A.L.L. (2016). HIV Manifestations of Posterior Segment. In: Gupta, V., Nguyen, Q., LeHoang, P., Herbort Jr., C. (eds) The Uveitis Atlas. Springer, New Delhi. https://doi.org/10.1007/978-81-322-2506-5_122-1

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  • DOI: https://doi.org/10.1007/978-81-322-2506-5_122-1

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