iris

ciliary body

choroid

• most common opportunistic infection in aids
• treatment- chemotherapy and immunosuppression

• CD4 less than 50 cells
• if CD4>50 but <100, we will examin every six months
• if above 100, examine yearly

• floaters
• photopsias
• scotomas
• blurred vision
• obstructed peripheral vision
• sudden decrease of vision

• frequently starts in periphery
• granular opacification
• slow progression
• no vasculitis
• mild vitritis

• dense, white, confluent opacification
• frequently along vascular arcades
• associated hemorrhage
• may be associated with venous sheathing
• mild vitritis

• Ganciclovir- systemic initially IV then oral
  • Foscarnet IV
  • Cidofovir IV
• intravitreal- injection or slow release devices
• goal: prevent progression
• CMV can be resistant

signs of regression

• fewer hemorrhage
• less opacification
• diffuse atrophic and pigmentary changes

• RD
• blidness
• low myelosuppresion w/use of ganciclovir
• kidney impairment with foscarnet
• seizures with foscarnet

• superficial retinal hemorrhage with red edges but pale or white centers
• seen in variety of conditions including infective endocarditis
• not pathognomonic of any particular disease

• iritis in 40% of cases
• within 3 weeks of onset

• affects healthy individuals
• for young- herpes simplex
• for old- herpes zoster
• complication
  • retinal detachment
  • ischemic optic neuropathy
• treatment
  • systemic acyclovir
  • steroids
  • aspirin
  • laser photocoagulation to limit progression

• lyme disease
• HIV
• herpes zoster
• herpes simplex
• Candidiasis
• histoplasmosis syndrome
• sec./tert. syphilis
• post prim. stage of TB
• toxoplasmosis
• CMV retinitis

• systemic steroids
• clindamycin
• sulphonamides
• pyrimethamide
• co-trimoxazole
• azithromycin
• atovaquone

• lesion at posterior pole, near optic disc or major blood vessel
• very sever vitritis

AIDS patients irrespective of location or severity

• etiology
  • idiopathic
  • associated w/autoimmune disease
• location
  • ant.
  • intermediate
  • post.
• treatment
  • initial corticosteroids
  • may require stronger immunosuppresion