Differential Diagnosis of the Retinal Manifestations of Acquired Immunodeficiency Syndrome

Ebert, Eleanore M.; D’Amico, Donald J.

doi:10.3109/08820539309060205

Cited by 2 publications

(2 citation statements)

References 65 publications

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“…The low number of injecting drug users in our series probably explains the absence of ocular infection by Candida or Aspergillus spp, despite the moderately high incidence of systemic infection of the former in both the British and American studies. There are a few well documented reports of ocular histoplasmosis13 and, contrary to our experience, of pneumocystosis14, toxoplasmosis,12 15tuberculosis,16 and Mycobacterium avium intracellulare choroiditis17 in AIDS patients in the literature. They are, nevertheless, as all three postmortem studies suggest, uncommon infections.…”

Section: Discussioncontrasting

confidence: 84%

“…Infection in the solitary case of toxoplasmosis in our series was confined to the brain, thus resembling the American experience,5 and although the French study3 revealed a much higher incidence of cerebral involvement, there was only one case in which the eyes were affected. This is interesting since a retinochoroiditis incidence of 3% is cited in respect of AIDS sufferers on clinical grounds 14. Possibly the reliability of such diagnoses should be questioned 15.…”

Section: Discussionmentioning

confidence: 99%

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Postmortem histological survey of the ocular lesions in a British population of AIDS patients

Pecorella

2000

British Journal of Ophthalmology

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Aims-To study ocular pathology and systemic correlations in a series of 73 postmortem eyes from British patients who died from AIDS before the introduction of a HAART regimen. Methods-The eyes were studied with conventional histology, special histochemical stainings, and immunohistochemistry. Results-72.6% of the cases showed chronic uveal inflammation, caused by opportunistic agents in 37.7% of them (cytomegalovirus (CMV) in 30.1%, C neoformans in 5.6%, and Gram positive bacteria in 1.8%). Cytoid bodies were noted in 10/73 eyes, three linked to CMV retinitis. Six retinal haemorrhages, four of which were secondary to CMV, were found. 14 specimens (19.1%) showed foci of calcification, and a further 11 (15%) calcium oxalate deposits. In no cases were the calcific deposits suspected clinically. Six eyes (8.2%) did not show any abnormality. Conclusions-CMV retinitis is the most common (28.7%, 21/73) ocular infection in this series and may occur either during or in the absence of systemic dissemination. Conversely, ocular cryptococcosis appears to be an epiphenomenon of systemic and CNS disease. No other opportunistic ocular infections were present in this series. Interesting findings were the presence of intraocular precipitates of calcium oxalate and calcium phosphate or carbonate in a significant number of cases (15% and 19%, respectively), and the high prevalence of idiopathic uveal inflammation (43.8%).

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Section: Discussioncontrasting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Postmortem histological survey of the ocular lesions in a British population of AIDS patients

Pecorella

2000

British Journal of Ophthalmology

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Ocular, cerebral and systemic interrelationships of cytomegalovirus infection in a postmortem study of AIDS patients

Pecorella

Ciardi

Credendino

et al. 1999

Eye

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CMV infection was observed in 63% of the cases. Visceral, cerebral and ocular involvement were overall 49%, 33% and 29%, respectively. The visceral form with no concomitant ocular and/or cerebral infection was the main cause of death (31%) in the 54 CMV-infected patients. Although CMV retinitis occurred mostly (20%) as a component of systemic disease, in 13% of the CMV-infected patients the eyes only were involved, while there were no cases with CMV limited to the brain. In the absence of systemic involvement, 9% of the cases showed concomitant ocular and cerebral infection, but because we failed to observe CMV optic neuritis without ocular involvement, retrograde viral spread from the brain through the optic nerve appears to be an infrequent mechanism of CMV retinitis.

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Differential Diagnosis of the Retinal Manifestations of Acquired Immunodeficiency Syndrome

Cited by 2 publications

References 65 publications

Postmortem histological survey of the ocular lesions in a British population of AIDS patients

Postmortem histological survey of the ocular lesions in a British population of AIDS patients

Ocular, cerebral and systemic interrelationships of cytomegalovirus infection in a postmortem study of AIDS patients

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