CHRONIC MULTIFOCAL RETINAL INFILTRATES IN PATIENTS INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS

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 i n filtrates of unknown cause seen by investigators at four institution s. The following data were collected: demographic characteristics, pre senting signs and symptoms, laboratory test results, and course of dis ease. RESULTS: We identified 26 HIV-infected pa patients (50 involved eyes) with this syndrome. Median CD4(+) T-lymphocyte count at presenta tion was 272 per mu l (range, 7 to 2,118 per mu l). The most common pr esenting symptom was floaters, Median visual acuity of involved eyes a t 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 gr ay-white or yellow, irregular in shape, and less than 200 mu m in grea test dimension, All were located in the midperiphery or anterior retin a and enlarged slowly or remained static in size, Mild to moderate ant erior 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 v itreous humor inflammatory reactions responded to topical or periocula r injections of corticosteroid. CONCLUSIONS: Uveitis with chronic mult ifocal retinal infiltrates is a distinct clinical entity of unknown ca use that occurs in HIV-infected patients. Retinal lesions may respond to antiretroviral therapy. Visual prognosis is good. (C) 1998 by Elsev ier Science Inc. All rights reserved.