Examen du fond d'oeil dans le cadre d'une affection a VIH: quoi de neuf? [Examination of the posterior eye segment during HIV infection: what is new?]

AIM: A patient was till now considered at high risk of developing a cytomegalovirus retinitis when the CD4+ cells were under 100/mm3. The risk was major when the CD4+ were under 50/mm3. With the onset of a Highly Active Antiretroviral Therapy (HAART) the follow-up of AIDS patients has changed. The introduction of a HAART is associated with an increase in CD4+ cells. The aim of the study was to highlight clinical modifications of classical AIDS associated ocular diseases. MATERIALS AND METHODS: Clinical observations will be correlated to recent data published in literature. RESULTS: An immune response can be present against opportunitic infections. Cytomegalovirus retinitis can present an atypical pattern: The host immune response can be responsible for an increase of ocular inflammation, a hypopyon can even be seen. An intense vitritis can be present and frosted angiitis syndrome can be observed. A severe macular edema can be present and has to be treated with posterior sub-Tenon's steroid injections. CONCLUSION: With the restoration of an immune response under HAART therapy, clinical manifestation of AIDS associated ocular diseases has changed and the differential diagnosis of ocular lesions must include endogenous uveitis