Retinal periphlebitis in patients with acquired immunodeficiency syndrome with cytomegalovirus retinitis mimics acute frosted retinal periphlebitis
M. F. Rabb, L. M. Jampol, R. H. Fish, R. V. Campo, W. M. Sobol and N. M. Becker
Department of Ophthalmology and Visual Sciences, University of Illinois, Chicago.
Acute frosted retinal periphlebitis is an inflammatory condition of unknown
origin characterized by marked perivenular infiltration in otherwise
healthy patients. We encountered seven patients with acquired
immunodeficiency syndrome who exhibited visual loss associated with an
unusual diffuse retinal periphlebitis very similar in appearance to acute
frosted retinal periphlebitis. Each patient developed a thick inflammatory
infiltrate surrounding the retinal venules, creating a frosted appearance.
Two cases were bilateral. All patients had areas of more typical
cytomegalovirus retinitis in their involved eye(s). Five of six patients
treated with ganciclovir sodium showed improvement not only of the
cytomegalovirus retinitis but also of the periphlebitis. Although we do not
have histopathologic evidence that cytomegalovirus was the cause of these
cases of periphlebitis, we believe that periphlebitis may be a previously
unrecognized finding of cytomegalovirus retinitis in patients with acquired
immunodeficiency syndrome. So far, there is no evidence implicating
cytomegalovirus as the cause of acute frosted retinal periphlebitis in
healthy patients.
