Immune-recovery uveitis in patients with cytomegalovirus retinitis taking highly active antiretroviral therapy

PURPOSE: To investigate the clinical features associated with immune recove ry in human immunodeficiency virus (HIV)-infected patients with cytomegalov irus retinitis who are taking highly active antiretroviral therapy. METHODS: Sixteen patients were evaluated prospectively at the National Eye Institute, Bethesda, Maryland. Evaluation included a medical history and a complete ophthalmologic examination. The examination included best correcte d visual acuity score measured by means of logarithmic charts, slit-lamp bi omicroscopy, dilated retinal examination, retinal photography, and fluoresc ein angiography. Immune-recovery uveitis was defined as the ocular inflamma tion associated with clinical immune the presence of moderate to severe mac ular edema on fluorescein angiography and vitreous haze (P less than or equ al to .001). CONCLUSIONS: Immune-recovery uveitis is an important cause of visual morbid ity in HIV-infected patients with cytomegalovirus retinitis in the era of h ighly active antiretroviral therapy. Although immune recovery associated wi th highly active antiretroviral therapy has allowed some patients to discon tinue specific anticytomegalovirus therapy, the rejuvenated immune response can be associated with sight-threatening inflammation. Published by Elsevi er Science Inc.