Klin Monbl Augenheilkd 2020; 237(04): 480-483
DOI: 10.1055/a-1068-2591
Der interessante Fall
Georg Thieme Verlag KG Stuttgart · New York

Bilateral Vitreous Haemorrhage and Peripheral Neovascularisation as Part of Occlusive Noninfectious HIV Microvasculopathy – Case Report

Bilaterale Glaskörperblutung und periphere Neovaskularisationen im Rahmen einer okklusiven, nicht infektiösen HIV-Mikrovaskulopathie – Fallbeispiel
Linda Oesterle
1  Department of Ophthalmology (Chairman Prof. Dr. med. Ch. Valmaggia), Cantonal Hospital St. Gallen, St. Gallen, Switzerland
,
Christophe Valmaggia
1  Department of Ophthalmology (Chairman Prof. Dr. med. Ch. Valmaggia), Cantonal Hospital St. Gallen, St. Gallen, Switzerland
,
Margarita Todorova
1  Department of Ophthalmology (Chairman Prof. Dr. med. Ch. Valmaggia), Cantonal Hospital St. Gallen, St. Gallen, Switzerland
2  Department of Ophthalmology (Chairman Prof. Dr. med. H. Scholl), University Hospital Basel, Basel, Switzerland
› Author Affiliations
Further Information

Publication History

received 25 September 2019

accepted 14 November 2019

Publication Date:
24 February 2020 (online)

Background

According to the report of the World Health Organization, from 37.9 million people globally living with human immunodeficiency virus (HIV), approximately two-thirds have received high active antiretroviral treatment (HAART) at the end of 2018 [1]. Nevertheless, a large majority of HIV patients still demonstrate a sight-threatening manifestation of the disease [2]. Apart from the lower number of CD4+ lymphocyte counts and higher HIV plasma viral load, nowadays, the presence of HIV retinopathy is linked to AIDS, and thus to increased mortality of HIV patients [3]. Therefore, its recognition is of importance for the management of generalised microvascular HIV disease. Not only opportunistic infectious retinochoroidal vasculitis, due to cytomegalovirus, pneumocystis carinii, syphilis, or fungal infection, but noninfectious conditions have also been linked to HIV retinopathy. Although, among the noninfectious HIV vasculopathies, mainly central and branch retinal occlusions have been reported [2], [4], up to 50% of HIV-infected individuals may show transiently appearing cotton wool spots, Roth spots, haemorrhages, capillary nonperfusion, or microaneurysms in the posterior pole, all of which are barely related to macrovasculopathy, but rather to a noninfectious microvasculopathy [5].

In the presented patientʼs case, we identified the noninfectious HIV microvasculopathy, rarely discussed so far, to be the major pathogenetic factor for presentation of bilateral peripheral retinal neovascularisation and vitreous haemorrhage.