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Research Letter |

Choroidopathy Associated With AIDS

Ruwan A. Silva, MD1; Daniel Castresana, MD2; Janet E. Davis, MD1
[+] Author Affiliations
1Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Florida
2Department of Internal Medicine, Miller School of Medicine, University of Miami, Florida
JAMA Ophthalmol. 2013;131(9):1235-1238. doi:10.1001/jamaophthalmol.2013.4207.
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Extract

Ciliochoroidal effusions occur when fluid accumulates within the suprachoroidal space. Inflammatory effusions causing bilateral angle-closure glaucoma have been reported as an exceedingly rare manifestation of the human immunodeficiency virus (HIV).1,2 We describe a patient with AIDS-associated bilateral choroidal effusions with a clinical course marked instead by ocular hypotony.

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Figures

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Figure 1.
Montage Posterior Segment Images

Montage posterior segment images of the right (A) and left (B) eyes at the initial visit reveal vitritis in the right eye and bilateral nasal ciliochoroidal effusions. C, Montage posterior segment image of the right eye at 4-month follow-up is notable for radial wedge-shaped regions of depigmentation with overlying tessellation, seen most prominently nasally. A similar region is seen superotemporally with extension into the central macula. D, Montage posterior segment image of the left eye at 4-month follow-up demonstrates a similar appearance, with vitreous opacity partially obscuring a view to the posterior pole.

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Figure 2.
Fluorescein Angiograms and Indocyanine Green Angiograms

Fluorescein angiography of the right eye demonstrates normal retinal vascular filling and patches of early hypofluorescence (A), which appear hyperfluorescent in later frames (B). Corresponding indocyanine green angiography similarly demonstrates early hypofluorescence (C), with continued hypofluorescence in later frames (D).

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Figure 3.
Optical Coherence Tomographic Images and Enhanced Depth Imaging Optical Coherence Tomographic Images

Optical coherence tomography of the right (A) and left (B) eyes demonstrates relatively normal inner retinal architecture. Subfoveally, the external limiting membrane and photoreceptor inner segment/outer segment lines of both eyes appear preserved. Temporally, these layers appear sporadically disrupted in both eyes, with similar areas of loss nasally in the left eye. Both eyes also demonstrate temporal retinal pigment epithelium and Bruch membrane complex thinning with hyperreflective material overlying this layer and increased choroidal reflectivity underlying it. Enhanced depth imaging optical coherence tomography of the right (C) and left (D) eyes demonstrates diffuse thinning of the choroid in both eyes.

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