Immune recovery uveitis in AIDS patients with cytomegalovirus retinitis treated with highly active antiretroviral therapy in Venezuela

J Fernando Arevalo, Aristides J. Mendoza, Yolanda Ferretti

Research output: Contribution to journalArticle

Abstract

Purpose: To determine the characteristics of immune recovery uveitis (IRU) in acquired immunodeficiency syndrome (AIDS) patients with inactive cytomegalovirus (CMV) retinitis who responded to highly active antiretroviral therapy (HAART) in a Venezuelan population. Methods: We examined 34 patients (50 eyes) with AIDS (HAART responders) and healed CMV retinitis. Patients were observed for a median of 19.3 months following an increase in the CD4 cell count. Ten eyes were treated with sub-Tenon space corticosteroid injections. An age-matched control group of patients with healed CMV retinitis who did not have IRU (30 eyes of 20 patients) was included to compare CMV surface area and complications. Results: We found that 12 (37.5%) of 32 HAART responders developed IRU (18 eyes). The clinical findings of these 18 eyes with IRU are presented. The clinical spectrum of inflammation included vitritis, macular edema, epiretinal membranes, anterior uveitis, macular hole, retinal detachment with proliferative vitreoretinopathy, and cataract. Eyes with IRU had a mean CMV surface area of 31.7%. However, eyes without IRU (control group) had a mean CMV surface area of 35% (P = 0.41). Periocular treatment resulted in vision improvement (in 90% of eyes) without reactivation of retinitis. Conclusions: Symptomatic IRU developed in a significant number of patients with CMV retinitis following successful HAART in a Venezuelan population. CMV surface area does not seem to be a risk factor for the development of IRU. Eyes with IRU respond favorably to antiinflammatory therapy without reactivation of retinitis.

Original languageEnglish (US)
Pages (from-to)495-502
Number of pages8
JournalRetina
Volume23
Issue number4
DOIs
StatePublished - Aug 2003

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Cytomegalovirus Retinitis
Venezuela
Uveitis
Highly Active Antiretroviral Therapy
Acquired Immunodeficiency Syndrome
Cytomegalovirus
Retinitis
Epiretinal Membrane
Proliferative Vitreoretinopathy
Anterior Uveitis
Control Groups
Retinal Perforations
Macular Edema
Retinal Detachment
CD4 Lymphocyte Count
Cataract
Population
Adrenal Cortex Hormones
Anti-Inflammatory Agents
Research Design

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

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Immune recovery uveitis in AIDS patients with cytomegalovirus retinitis treated with highly active antiretroviral therapy in Venezuela. / Arevalo, J Fernando; Mendoza, Aristides J.; Ferretti, Yolanda.

In: Retina, Vol. 23, No. 4, 08.2003, p. 495-502.

Research output: Contribution to journalArticle

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