AIM: To investigate the clinical characteristics of acquired immunodeficiency syndrome(AIDS)complicated with cytomegalovirus(CMV)retinopathy(CMVR), and the clinical manifestations of immune reconstruction inflammatory syndrome(IRIS)in eye.

METHODS: Patients who accepted treatments diagnosed with AIDS in our hospital of Department of Infectious Disease from Jan. 2010 to Dec. 2015 were retrospective analyzed. Sixty cases(103 eyes)with cytomegalovirus retinitis were identified. The clinical symptoms, the fundus manifestation, CD4⁺T cell count and the prognosis were examined.

RESULTS: Visual acuity of 65 eyes(63.1%), 26 eyes(25.2%), and 12 eyes(11.7%)were ≤0.1, 0.1-0.3 and ≥0.3 respectively. The fundus manifestations had yellow-white lesions along vascular distribution and hemorrhage of retina. The vitreous body was rarely involved. The retinal necroses in 37 eyes(35.9%)involved the posterior pole, 45 eyes(43.7%)involved peripheral region, and 21 eyes(20.4%)with mixed type. In 60 patients, CD4⁺T cells counts was 38.6±12.3 cells/μL on average, 43 cases(71.7%)of CD4⁺T cells is ≤50 cells/μL, 8 cases(13.3%)of CD4⁺T cells >50-100 cells/μL, and 9 cases(15.0%)>100 cells/μL. Visual acuity of 89 eyes improved with highly active antiretroviral therapy(HARRT)and anti-CMV treatment, 19 eyes unchanged, 18 eyes decreased, and CD4⁺T cells counts was significantly higher(P<0.05). Five patients(9 eyes)with IRIS were responded well to treatment.

CONCLUSION: CMVR is a common intraocular complication of AIDS. Routine fundus examination should be performed when the CD4⁺T cells counts is less than ≤50 cells/μL. Immune reconstitution inflammatory syndrome CMV retinopathy has worse in the prognosis.