Evidence for cytomegalovirus and human immunodeficiency virus infection of the retina in AIDS.

Characteristic ophthalmopathological features of retinal lesions in a patient with the acquired immunodeficiency syndrome (AIDS) are reported. In situ hybridization, immunohistochemistry and electron microscopy revealed severe unilateral cytomegalovirus (CMV) retinitis. The opposite retina which was not involved by CMV showed nonspecific signs of ischaemia in the nerve fiber layer corresponding to cotton-wool spots. Occasional cells of both retinas were positively stained by a mouse monoclonal antibody to the p24 HIV-1 antigen indicating infection of retinal cells by HIV. It is suggested that HIV may directly or indirectly damage retinal tissue and interact with opportunistic pathogens, thus leading to a variety of ocular abnormalities associated with AIDS.