Immune recovery vitritis

Abstract

Introduction Immune recovery vitritis (IRV) is symptomatic vitritis of > 1+ severity associated with inactive cytomegalovirus (CMV) retinitis. It is an opportunistic infection of the eye, in the patients who suffer from AIDS, and is treated with a highly active antiretroviral therapy (HAART). As a result of this therapy, there is an immune reconstitution in the body and inflammation of the vitreous body. Objective The aim of the study was to show the incidence of IRV in patients treated with HAART. Method A retrospective study was conducted in patients who suffered from CMV retinitis. Twenty-one were treated with HAART and had the diagnosis of CMV retinitis, as well. All of them were examined by the same ophthalmologist who peformed slit lamp examination with mydriasis and indirect ophthalmoscopy. Results Nine of 21 patients developed IRV as a complication of HAART, two had cystoid macular edema (CMO). Conclusion CMV retinitis develops when the number of CD4+ T lymphocytes drops below 50/mm3. This results in necrotic retinitis which, if untreated, leads to complete loss of vision. With the introduction of HAART, we learned that the reconstitution of immune status was achieved as well as life expectancy, but there was a dramatic decline in the opportunistic infection, including CMV retinitis, as well. With the immune reconstitution, the inflammation develops in the eye, known as IRV. Sometimes, it is necessary to treat this condition, but in the case of our patients, the inflammation was mild, and no treatment was necessary.