DZI20-173-Case-5
Middle-aged patient with HIV and loss of vision.
Cytomegalovirus retinitis. On one side of the optic nerve head the retina is atrophic with no neural structures remaining. On the other side there is atrophic retina followed by intact retina. In the boundary between the intact and absent retina one can see the boundary zone with numerous nuclear and cytoplasmic inclusions that represent viral cytopathic effect. Such inclusions are also seen in the optic nerve just posterior to the lamina cribrosa. They are also seen at the extreme periphery of the retina, near the ora serrata, on the side of the eye with mostly atrophic retina. Incidentally, in the region of intact retina away from the boundary region of active virus replication, one can see occasional areas of chorioretinal scars with absence mostly of the outer retina and retinal pigment epithelium. Those are the residual of photocoagulation scars due to laser panretinal photocoagulation that the patient received to treat early diabetic retinopathy. Note that there are also a few intraretinal hemorrhages, also attributed to diabetic retinopathy.
December 31, 1969 7:00:00 PM
