Optical Coherence Tomography (OCT) Findings of Unilateral Ischemic Maculopathy Associated with CMV Retinitis In Patient With AIDS

Abstract

Cytomegalovirus (CMV) retinitis in Acquired Immuno-Deficiency Syndrome (AIDS) patients is quite common entity. But unilateral ischemic maculopathy associated with CMV retinitis in Acquired immunodeficiency syndrome (AIDS) is very rare. We report a 43 years old female who presented to our hospital with decreased visual acuity and floaters. Optical coherence tomography (OCT) demonstrated increased reflectivity at the inner retinal layer with a preponderance in the nasal area of the macula and macular oedema. The patient was treated with oral valgancyclovir, started on HAART, and administered a high dose of intravitreal ganciclovir (5.0 mg/0.1 ml once a week) for 5 doses followed by panretinal photocoagulation in the RE, which controlled the retinitis and rubeosis iridis. After 6months, best corrected visual acuity (BCVA) was 6/60 in the RE with an increase in retinal thickness in the temporal area of the fovea, healed CMV retinitis and small amount of SRF remained, as demonstrated by OCT. Ischemic maculopathy may cause a severe and permanent decrease in vision in AIDS patients. CMV retinitis plays a role in the pathogenesis of ischemic maculopathy. Fluorescein angiography and OCT should be considered in any patient with AIDS and unexplained visual loss.