Chronic multifocal retinal infiltrates in patients infected with human immunodeficiency virus

Ralph D. Levinson, Robin Vann, Janet L Davis, Dorothy N. Friedberg, Adnan Tufail, Brian T. Terry, Janette I. Lindley, Gary N. Holland

Research output: Contribution to journalArticle

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Abstract

PURPOSE: To describe the clinical features of a disorder characterized by chronic multifocal retinal infiltrates and uveitis in individuals with human immunodeficiency virus (HIV) disease. METHODS: We reviewed the medical records of HIV-infected patients with multifocal retinal infiltrates of unknown cause seen by investigators at four institutions. The following data were collected: demographic characteristics, presenting signs and symptoms, laboratory test results, and course of disease. RESULTS: We identified 26 HIV-infected patients (50 involved eyes) with this syndrome. Median CD4+ T- lymphocyte count at presentation was 272 per μl (range, 7 to 2,118 per μl). The most common presenting symptom was floaters. Median visual acuity of involved eyes at presentation was 20/20 (range, 20/15 to 20/100) and remained stable (median, 20/20; range, 20/15 to 20/70) after a median follow-up period of 9 months (range, 0 to 110 months). Typical retinal lesions were gray- white or yellow, irregular in shape, and less than 200 μm in greatest dimension. All were located in the midperiphery or anterior retina and enlarged slowly or remained static in size. Mild to moderate anterior chamber or vitreous humor inflammatory cells were present in 47 of 50 eyes (26 of 26 patients). Retinal lesions possibly responded to zidovudine but not to acyclovir or ganciclovir. Anterior chamber and vitreous humor inflammatory reactions responded to topical or periocular injections of corticosteroid. CONCLUSIONS: Uveitis with chronic multifocal retinal infiltrates is a distinct clinical entity of unknown cause that occurs in HIV-infected patients. Retinal lesions may respond to antiretroviral therapy. Visual prognosis is good.

Original languageEnglish
Pages (from-to)312-324
Number of pages13
JournalAmerican Journal of Ophthalmology
Volume125
Issue number3
DOIs
StatePublished - Mar 1 1998

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HIV
Vitreous Body
Uveitis
Anterior Chamber
Intraocular Injections
Ganciclovir
Acyclovir
Zidovudine
Virus Diseases
CD4 Lymphocyte Count
Visual Acuity
Signs and Symptoms
Medical Records
Retina
Adrenal Cortex Hormones
Research Personnel
Demography
T-Lymphocytes
Therapeutics

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Chronic multifocal retinal infiltrates in patients infected with human immunodeficiency virus. / Levinson, Ralph D.; Vann, Robin; Davis, Janet L; Friedberg, Dorothy N.; Tufail, Adnan; Terry, Brian T.; Lindley, Janette I.; Holland, Gary N.

In: American Journal of Ophthalmology, Vol. 125, No. 3, 01.03.1998, p. 312-324.

Research output: Contribution to journalArticle

Levinson, RD, Vann, R, Davis, JL, Friedberg, DN, Tufail, A, Terry, BT, Lindley, JI & Holland, GN 1998, 'Chronic multifocal retinal infiltrates in patients infected with human immunodeficiency virus', American Journal of Ophthalmology, vol. 125, no. 3, pp. 312-324. https://doi.org/10.1016/S0002-9394(99)80137-8
Levinson, Ralph D. ; Vann, Robin ; Davis, Janet L ; Friedberg, Dorothy N. ; Tufail, Adnan ; Terry, Brian T. ; Lindley, Janette I. ; Holland, Gary N. / Chronic multifocal retinal infiltrates in patients infected with human immunodeficiency virus. In: American Journal of Ophthalmology. 1998 ; Vol. 125, No. 3. pp. 312-324.
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