Acquired immune deficiency syndrome. Pathogenic mechanisms of ocular disease. NLM AIDSLINE Important note: Information in this article was accurate in 1985. The state of the art may have changed since the publication date.

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Acquired immune deficiency syndrome. Pathogenic mechanisms of ocular disease.

Ophthalmology. 1985 Apr;92(4):472-84. Unique Identifier : AIDSLINE MED/85214903
Pepose JS; Holland GN; Nestor MS; Cochran AJ; Foos RY

Abstract: A gross, light, and electron microscopic study of the eyes from 35 consecutive autopsy cases of the acquired immune deficiency syndrome revealed cotton-wool spots (71% of cases), retinal hemorrhage in areas without cytomegalovirus infection (40%), cytomegalovirus retinitis (34%) with associated retinal detachment, Roth's spots (23%), retinal microaneurysms (20%), papilledema (14%), conjunctival Kaposi's sarcoma (9%), cryptococcal chorioretinitis (6%), Mycobacterium avium-intracellulare in retina and in choroidal granulomas (6%), ischemic maculopathy (6%), bilateral keratitis (3%), and herpes simplex retinitis (3%). Ocular infection with candida or toxoplasmosis were not found in this autopsy series. Immunocytologic studies demonstrated deposition of immunoglobulins in arteriolar walls, consistent with immune complex mediated disease. Ultrastructural studies showed a vasculopathy in the areas near cotton-wool spots. A mechanism is proposed linking the deposition of immune complexes with subsequent small vessel lesions, ischemia, cotton-wool spots and later spread of cytomegalovirus to retina via damaged vascular endothelium.
Keywords: Acquired Immunodeficiency Syndrome/*PATHOLOGY/PHYSIOPATHOLOGY Adult Bacterial Infections/EPIDEMIOLOGY Capillaries/PATHOLOGY Conjunctival Neoplasms/PATHOLOGY Cytomegalovirus Infections/PATHOLOGY Eye Diseases/*PATHOLOGY/PHYSIOPATHOLOGY Human Immune Complex Diseases/PATHOLOGY Male Middle Age Retinitis/PATHOLOGY Sarcoma, Kaposi's/PATHOLOGY Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. Virus Diseases/EPIDEMIOLOGY JOURNAL ARTICLE

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Copyright © 1985 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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