Abstract
Purpose Eighty-six post-mortems of AIDS patients were reviewed microscopically and the presence of cytomegalovirus (CMV) infection in the viscera, brain and eye was recorded.
Methods Immunohistochemical stains and in situ hybridisation with a CMV probe were performed.
Results and conclusion CMV infection was observed in 63% of the cases. Visceral, cerebral and ocular involvement were overall 49%, 33% and 29%, respectively. The visceral form with no concomitant ocular and/or cerebral infection was the main cause of death (31%) in the 54 CMV-infected patients. Although CMV retinitis occurred mostly (20%) as a component of systemic disease, in 13% of the CMV-infected patients the eyes only were involved, while there were no cases with CMV limited to the brain. In the absence of systemic involvement, 9% of the cases showed concomitant ocular and cerebral infection, but because we failed to observe CMV optic neuritis without ocular involvement, retrograde viral spread from the brain through the optic nerve appears to be an infrequent mechanism of CMV retinitis.
Similar content being viewed by others
Article PDF
References
Yoser SL, Forster DJ, Rao NA . Systemic viral infections and their retinal and choroidal manifestations. Surv Ophthalmol 1993;37:313–51.
Henderly DE, Freeman WR, Smith RE, Causey D, Rao NA . Cytomegalovirus retinitis as the initial manifestation of the acquired immune deficiency syndrome. Am J Ophthalmol 1987;103:316–20.
Murray HW, Knox DL, Green WR, Susel RM . Cytomegalovirus retinitis in adults: a manifestation of disseminated vital infection. Am J Med 1977;63:574–84.
Casale Turu A, Civera AA, Latorre X . Ophthalmic manifestations of acquired immune deficiency syndrome: a study of thirty-four patients. Ophthalmologica 1988;197:113–9.
Moeller MB, Gutman RQ, Hamilton JD . Acquired cytomegalovirus retinitis: four new cases and a review of the literature with implications for management. Am J Nephrol 1982;2:251–5.
De Girolami U, Hénin D, Girard B, Katlama C, Le Hoang P, Hauw JJ . Etude pathologique de l'oeil et du système nerveux central dans 25 cas de SIDA. Rev Neurol (Paris) 1989;145:819–28.
Morinelli EN, Dugel PU, Lee M, Klatt EC, Rao NA . Opportunistic intraocular infections in AIDS. Trans Am Ophthalmol Soc 1992;90:96–109.
Pepose JS, Holland GN, Nestor MS, Cochran AJ, Foos RY . Acquired immunodeficiency syndrome: pathogenic mechanisms of ocular disease. Ophthalmology 1985;92:472–84.
Seregard S . Retinochoroiditis in the acquired immune deficiency syndrome: findings in consecutive post-mortem examinations. Acta Ophthalmol (Copenh) 1994;72:223–8.
Jensen OA, Klinken L . Pathology of brain and eye in the acquired immune deficiency syndrome (AIDS): a comparison of lesions in a consecutive autopsy material. APMIS 1989;97:325–33.
Morgello S, Cho ES, Nielsen S, Devinsky O, Petito CK . Cytomegalovirus encephalitis in patients with acquired immunodeficiency syndrome: an autopsy study of 30 cases and a review of me literature. Hum Pathol 1987;18:289–97.
Achim CL, Wang R, Miners DK, Wiley CA . Detection of cytomegalovirus in cerebrospinal fluid autopsy specimens from AIDS patients. J Infect Dis 1994;169:623–7.
Holland NR, Power C, Mathews VP, Glass JD, Forman M, McArthur JC . Cytomegalovirus encephalitis in acquired immunodeficiency syndrome (AIDS). Neurology 1994;44:507–14.
Faber DW, Wiley CA, Lynn GB, Gross JG, Freeman WR . Role of HIV and CMV in the pathogenesis of retinitis and retinal vasculopathy in AIDS patients. Invest Ophthalmol Vis Sci 1992;33:2345–53.
Culbertson WW . Infections of the retina in AIDS. Int Ophthalmol Clin 1989;29:108–18.
Roarty JD, Fisher EJ, Nussbaum JJ . Long-term visual morbidity of CMV retinitis in patients with acquired immune deficiency syndrome. Ophthalmology 1993;100:1685–8.
Ebert EM, D'Amico DJ . Differential diagnosis of the retinal manifestations of acquired immunodeficiency syndrome. Semin Ophthalmol 1993;8:2–14.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pecorella, I., Ciardi, A., Credendino, A. et al. Ocular, cerebral and systemic interrelationships of cytomegalovirus infection in a postmortem study of AIDS patients. Eye 13, 781–785 (1999). https://doi.org/10.1038/eye.1999.228
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1038/eye.1999.228
Keywords
This article is cited by
-
CMV retinitis in China and SE Asia: the way forward
BMC Infectious Diseases (2011)
-
CMV retinitis screening and treatment in a resource‐poor setting: three‐year experience from a primary care HIV/AIDS programme in Myanmar
Journal of the International AIDS Society (2011)
-
Retrobulbar Optic Neuritis and Meningoencephalitis Following Progressive Outer Retinal Necrosis due to CMV in a Patient with AIDS
Infection (2008)