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September 1995, Vol 113, No. 9 >
ARTICLE | September 1995

Bilateral Central Retinal Vein Occlusions in a Patient With Acquired Immunodeficiency Syndrome: Title and subTitle BreakClinicopathologic Correlation FREE

Scott M. Friedman, MD; Curtis E. Margo, MD
Arch Ophthalmol. 1995;113(9):1184-1188. doi:10.1001/archopht.1995.01100090110031
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Four patients with human immunodeficiency virus (HIV) infection and central retinal vein occlusion have been previously described in the literature. The pathologic findings in a fifth patient with this association are reported. The histopathologic findings were similar to ischemic central retinal vein occlusion in persons without HIV infections. There was no evidence of HIV in vascular endothelial cells using electron microscopy and in situ hybridization techniques. The failure to identify any structual or direct infectious cause for central retina vein occlusion in this setting suggests that other hemorheologic factors related to HIV infection are probably responsible for the predispostion to vascular thrombosis.

REFERENCES

1 +
Tiech SA, Sonnabend J.  Central retinal vein occlusion in a patient with AIDS . Arch Ophthalmol . 1988;;106:1508-1509.
2 +
Ismail Y, Nemeckek PM, Arsur EL.  A rare cause of visual loss in AIDS patients: central retinal vein occlusion . Br J Ophthalmol . 1993;;77:600-601.
3 +
Roberts SA, Haefs TMP.  Central retinal vein occlusion in a middle-aged adult with HIV infection . Optom Vis Sci . 1992;;69:567-569.
4 +
Goldsmith W, Buckner J.  Central retinal vein occlusion in an AIDS patient: a case report . South J Optom . 1992;;10:35-38.
5 +
Martin AW, Brady K, Smith SI, et al.  Immunohistochemical localization of human immunodeficiency virus p24 antigen in placental tissue . Hum Pathol . 1992;;23:411-414.
6 +
Fox CH, Tenner-Rácz, Rácz P, Firpo A, Pizzo PA, Fauci AS.  Lymphoid germinal centers are reservoirs of human immunodeficiency virus type 1 RNA . J Infect Dis . 1991;;164:1051-1057.
7 +
Ellis CJ, Hamer DB, Hunt RW, et al.  Medical investigation of retinal vascular occlusion . BMJ . 1964;;2:1093-1098.
8 +
Kohner EM, Cappin JM.  Do medical conditions have an influence on CRVO? Proc R Soc Med . 1974;;76:1052-1054.
9 +
McGrath MA, Wechsler F, Hunyor ABL, Penny R.  Systemic factors contributory for retinal vein occlusion . Arch Intern Med . 1978;;138:216-220.
10 +
Dodson PM, Galton DJ, Hamilton AM, Blach RK.  Retinal vein occlusion and prevalence of lipoprotein abnormalities . Br J Ophthalmol . 1982;;66:161-164.
11 +
Brown GC, Shah HG, Magargal LE, Savino PJ.  CRVO and carotid artery disease . Ophthalmology . 1984;;91:1627-1633.
12 +
Walters RF, Spalton DJ.  Central retinal vein occlusion in people 40 years or less: a review of 17 patients . Br J Ophthalmol . 1990;;74:30-35.
13 +
Fong ACO, Schatz H.  Central retinal vein occlusion in young adults . Surv Ophthalmol . 1993;;37:393-418.
14 +
Chen V, Moisseiev J, Treister G.  Severe ischemic process in a young man with CRVO . Metab Pediatr Syst Ophthamol . 1988;;11:67-69.
15 +
Fong ACO, Schatz H, MacDonald HR, et al.  Central retinal vein occlusion in young adults (papillophlebitis) . Retina . 1992;;12:3-11.
16 +
Hayreh SS, Rohas R, Podhajsky P, Montague P, Woolson RF.  Ocular neovascularization with retinal vascular occlusion, III: incidence of ocular neovascularization with retinal vein occlusion . Ophthalmology . 1983;;90:488-506.
17 +
Green WR, Chan CC, Hutchins GM, Terry JM.  Central retinal vein occlusion: a retrospective histopathologic study of 29 eyes in 28 cases . Retina . 1981;;1:27-55.
18 +
Green WR, Chan CC, Hutchins GM, Terry HM.  A prospective histopathologic study of 29 eyes of 28 patients . Trans Am Ophthalmol Soc . 1981;;79:371-422.
19 +
Green WR.  Histopathologic studies of hypotensive retinopathy, branch vein occlusion, and central retinal vein occlusion . In: Fine SL, Owens SL, eds. Management of Retinal Vascular and Macular Disorders . Baltimore, Md: Williams & Wilkins; 1983;:5-27.
20 +
Appen RE, DeVenecia G, Gerwera J.  Optic disc vasculitis . Am J Ophthalmol . 1980;;90:352-359.
21 +
Caskey PJ, Ai E.  Posterior segment manifestation of AIDS . Ophthalmol Clin North Am . 1990;;3:393-412.
22 +
Canoso RT, Zon LI, Groopman JE.  Anticardiolipin antibodies associated with HTLV-III infection . Br J Haematol . 1987;;65:495-498.
23 +
Cohen AJ, Philips TM, Kessler CM.  Circulating coagulation inhibitors in the acquired immunodeficiency syndrome . Ann Intern Med . 1985;;104:175-180.
24 +
Stimmler MM, Quismorio FP Jr, McGehee WG, Boylen T, Sharma OP.  Anticardiolipin antibodies in acquired immunodeficiency syndrome . Arch Intern Med . 1989;;149:1833-1835.
25 +
Cappell MS, Simon T, Tiku M.  Splenic infarction associated with anticardiolipin antibodies in a patient with acquired immunodeficiency syndrome . Dig Dis Sci . 1993;;37:1152-1155.
26 +
Pumarola-Suna T, Navia BA, Cordon-Cardo C, Cho E-S, Price RW.  HIV antigen in the brains of patients with the AIDS dementia complex . Ann Neurol . 1987;;21:490-496.
27 +
Ward JM, O'Leary TJ, Baskin GB, et al.  Immunohistochemical localization of human simian immunodeficiency viral antigens in fixed tissue sections . Am J Pathol . 1987;;127:199-205.
28 +
Wiley CA, Schrier RD, Nelson JA, et al.  Cellular localization of human immunodeficiency virus infection within the brains of acquired immune deficiency syndrome patients . Proc Natl Acad Sci U S A . 1986;;83:7089-7093.
29 +
Mizusawa H, Hirano JFL, Shintaku M.  Cerebrovascular lesions in acquired immune deficiency syndrome (AIDS) . Acta Neuropathol . 1988;;76:451-457.
30 +
Cho E-S, Sharer LR, Peress NS, et al.  Intimal proliferation of leptomeningeal arteries and brain infarcts in subjects with AIDS . J Neuropathol Exp Neurol . 1987;;46:385. Abstract.
31 +
Cantrill HL, Henry K, Jackson B, Erice A, Ussery FM, Balfour Jr HH.  Recovery of human immunodeficiency virus from ocular tissues in patients with acquired immunodeficiency syndrome . Ophthalmology . 1988;;95:1458-1462.
32 +
Pomerantz RJ, Kuritzkes DR, de la Monte SM, et al.  Infection of the retina by human immunodeficiency virus type I . N Engl J Med . 1987;;317:1643-1647.
33 +
Schmitt-Graff A, Neuen-Jacob E, Rettig B, Sundmarcher R.  Evidence for cytomegalovirus and human immunodeficiency virus infection of the retina in AIDS . Virchows Arch A Pathol Anat . 1990;;416:249-253.
34 +
Skolnik PR, Pomerantz RJ, de la Monte SM, et al.  Dual infection of retina with human immunodeficiency virus type I and cytomegalovirus . Am J Ophthalmol . 1989;;107:361-372.
35 +
Rummelt V, Rummelt C, Jahn G, et al.  Triple retinal infection with human immunodeficiency virus type 1, cytomegalovirus, and herpes simplex virus type 1: light and electron microscopy, immunohistochemistry, and in situ hybridization . Ophthalmology . 1994;;101:270-279.
36 +
Engstrom RE Jr, Holland GN, Hardy WD, Meiselman JH.  Hemorheologic abnormalities in patients with human immunodeficiency virus infection and ophthalmic microvasculopathy . Am J Ophthalmol . 1990;;109:153-161.

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1 +
Tiech SA, Sonnabend J.  Central retinal vein occlusion in a patient with AIDS . Arch Ophthalmol . 1988;;106:1508-1509.
2 +
Ismail Y, Nemeckek PM, Arsur EL.  A rare cause of visual loss in AIDS patients: central retinal vein occlusion . Br J Ophthalmol . 1993;;77:600-601.
3 +
Roberts SA, Haefs TMP.  Central retinal vein occlusion in a middle-aged adult with HIV infection . Optom Vis Sci . 1992;;69:567-569.
4 +
Goldsmith W, Buckner J.  Central retinal vein occlusion in an AIDS patient: a case report . South J Optom . 1992;;10:35-38.
5 +
Martin AW, Brady K, Smith SI, et al.  Immunohistochemical localization of human immunodeficiency virus p24 antigen in placental tissue . Hum Pathol . 1992;;23:411-414.
6 +
Fox CH, Tenner-Rácz, Rácz P, Firpo A, Pizzo PA, Fauci AS.  Lymphoid germinal centers are reservoirs of human immunodeficiency virus type 1 RNA . J Infect Dis . 1991;;164:1051-1057.
7 +
Ellis CJ, Hamer DB, Hunt RW, et al.  Medical investigation of retinal vascular occlusion . BMJ . 1964;;2:1093-1098.
8 +
Kohner EM, Cappin JM.  Do medical conditions have an influence on CRVO? Proc R Soc Med . 1974;;76:1052-1054.
9 +
McGrath MA, Wechsler F, Hunyor ABL, Penny R.  Systemic factors contributory for retinal vein occlusion . Arch Intern Med . 1978;;138:216-220.
10 +
Dodson PM, Galton DJ, Hamilton AM, Blach RK.  Retinal vein occlusion and prevalence of lipoprotein abnormalities . Br J Ophthalmol . 1982;;66:161-164.
11 +
Brown GC, Shah HG, Magargal LE, Savino PJ.  CRVO and carotid artery disease . Ophthalmology . 1984;;91:1627-1633.
12 +
Walters RF, Spalton DJ.  Central retinal vein occlusion in people 40 years or less: a review of 17 patients . Br J Ophthalmol . 1990;;74:30-35.
13 +
Fong ACO, Schatz H.  Central retinal vein occlusion in young adults . Surv Ophthalmol . 1993;;37:393-418.
14 +
Chen V, Moisseiev J, Treister G.  Severe ischemic process in a young man with CRVO . Metab Pediatr Syst Ophthamol . 1988;;11:67-69.
15 +
Fong ACO, Schatz H, MacDonald HR, et al.  Central retinal vein occlusion in young adults (papillophlebitis) . Retina . 1992;;12:3-11.
16 +
Hayreh SS, Rohas R, Podhajsky P, Montague P, Woolson RF.  Ocular neovascularization with retinal vascular occlusion, III: incidence of ocular neovascularization with retinal vein occlusion . Ophthalmology . 1983;;90:488-506.
17 +
Green WR, Chan CC, Hutchins GM, Terry JM.  Central retinal vein occlusion: a retrospective histopathologic study of 29 eyes in 28 cases . Retina . 1981;;1:27-55.
18 +
Green WR, Chan CC, Hutchins GM, Terry HM.  A prospective histopathologic study of 29 eyes of 28 patients . Trans Am Ophthalmol Soc . 1981;;79:371-422.
19 +
Green WR.  Histopathologic studies of hypotensive retinopathy, branch vein occlusion, and central retinal vein occlusion . In: Fine SL, Owens SL, eds. Management of Retinal Vascular and Macular Disorders . Baltimore, Md: Williams & Wilkins; 1983;:5-27.
20 +
Appen RE, DeVenecia G, Gerwera J.  Optic disc vasculitis . Am J Ophthalmol . 1980;;90:352-359.
21 +
Caskey PJ, Ai E.  Posterior segment manifestation of AIDS . Ophthalmol Clin North Am . 1990;;3:393-412.
22 +
Canoso RT, Zon LI, Groopman JE.  Anticardiolipin antibodies associated with HTLV-III infection . Br J Haematol . 1987;;65:495-498.
23 +
Cohen AJ, Philips TM, Kessler CM.  Circulating coagulation inhibitors in the acquired immunodeficiency syndrome . Ann Intern Med . 1985;;104:175-180.
24 +
Stimmler MM, Quismorio FP Jr, McGehee WG, Boylen T, Sharma OP.  Anticardiolipin antibodies in acquired immunodeficiency syndrome . Arch Intern Med . 1989;;149:1833-1835.
25 +
Cappell MS, Simon T, Tiku M.  Splenic infarction associated with anticardiolipin antibodies in a patient with acquired immunodeficiency syndrome . Dig Dis Sci . 1993;;37:1152-1155.
26 +
Pumarola-Suna T, Navia BA, Cordon-Cardo C, Cho E-S, Price RW.  HIV antigen in the brains of patients with the AIDS dementia complex . Ann Neurol . 1987;;21:490-496.
27 +
Ward JM, O'Leary TJ, Baskin GB, et al.  Immunohistochemical localization of human simian immunodeficiency viral antigens in fixed tissue sections . Am J Pathol . 1987;;127:199-205.
28 +
Wiley CA, Schrier RD, Nelson JA, et al.  Cellular localization of human immunodeficiency virus infection within the brains of acquired immune deficiency syndrome patients . Proc Natl Acad Sci U S A . 1986;;83:7089-7093.
29 +
Mizusawa H, Hirano JFL, Shintaku M.  Cerebrovascular lesions in acquired immune deficiency syndrome (AIDS) . Acta Neuropathol . 1988;;76:451-457.
30 +
Cho E-S, Sharer LR, Peress NS, et al.  Intimal proliferation of leptomeningeal arteries and brain infarcts in subjects with AIDS . J Neuropathol Exp Neurol . 1987;;46:385. Abstract.
31 +
Cantrill HL, Henry K, Jackson B, Erice A, Ussery FM, Balfour Jr HH.  Recovery of human immunodeficiency virus from ocular tissues in patients with acquired immunodeficiency syndrome . Ophthalmology . 1988;;95:1458-1462.
32 +
Pomerantz RJ, Kuritzkes DR, de la Monte SM, et al.  Infection of the retina by human immunodeficiency virus type I . N Engl J Med . 1987;;317:1643-1647.
33 +
Schmitt-Graff A, Neuen-Jacob E, Rettig B, Sundmarcher R.  Evidence for cytomegalovirus and human immunodeficiency virus infection of the retina in AIDS . Virchows Arch A Pathol Anat . 1990;;416:249-253.
34 +
Skolnik PR, Pomerantz RJ, de la Monte SM, et al.  Dual infection of retina with human immunodeficiency virus type I and cytomegalovirus . Am J Ophthalmol . 1989;;107:361-372.
35 +
Rummelt V, Rummelt C, Jahn G, et al.  Triple retinal infection with human immunodeficiency virus type 1, cytomegalovirus, and herpes simplex virus type 1: light and electron microscopy, immunohistochemistry, and in situ hybridization . Ophthalmology . 1994;;101:270-279.
36 +
Engstrom RE Jr, Holland GN, Hardy WD, Meiselman JH.  Hemorheologic abnormalities in patients with human immunodeficiency virus infection and ophthalmic microvasculopathy . Am J Ophthalmol . 1990;;109:153-161.

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