In the early stages, CMV retinitis may resemble cotton wool spots as seen in HIV retinopathy. However, unlike the cotton wool spots in HIV retinopathy which tend to be multiple and transient, the lesions seen in CMV retinitis tend to be solitary and show enlargement over time.
The retinitis spread along the retinal vessels with white lesions and scattered haemorrhages. The involved vessels show sheathing. The retina behind the advancing edge may be atrophy. The vitreous is quiet and contains little cells.
- Hickman's line in the upper chest for intravenous drug administration. However, in some centres, the patient may have intraocular implant instead. (Note: the use of intravenous line is becoming less common with the use of HAART)
Look for AIDS defining lesions such as molluscum contagiosum and Kaposi's sarcoma
1. What is the most important factor in predicting the development of CMV retinitis in AIDS patient?