An HIV patient complains for visual disturbances fundal examination shows bilateral retinal exudates and perivascular hemorrhages. Which of the following viruses are most likely to be responsible for this retinitis :
Ophthalmologic manifestations of HIV infection
• The MC abnormal finding on fundus examination are “cotton wool spots”. They represent area of retinal ischemia secondary to microvascular disease. These lesions are not associated with visual loss.
• CMV Retinitis :
– MC cause of vision loss in AIDS patient.
– Usually occurs when CD-4 <50/ μ l.
– Usually present as painless progressive of vision, patient may also complain of floaters and scintillations.
– The characteristic appearance is that of perivascular hemorrhage and exudate.
– It may be complicated by rheumatogenous retinal detachment.
– Treatment - oral valganciclovir, IV ganciclovir - DOC
• Acute retinal necrosis syndrome = Progressive outer retinal necrosis (PORN) :
– Caused by herpes simplex virus, varicella zoster virus.
– Associated with pain, keratopathy iritis.
– Ophthalmologic examination show widespread pale grey lesions.
– DOC is intravenous acyclovir.
• Other secondary infections include :
– P.carnii - Cause lesion of choroid.
– Toxoplasmosis - Cause chorioretinitis.
Herpes  simplex  retinitis
Human  herpes  virus
Cytomegalovirus
EBV