Cytomegalovirus (CMV) retinitis occurs most often in patients with the acquired immunodeficiency syndrome (AIDS) whose absolute CD4+ lymphocyte count is less than 0.05× 109/L.1 Routine screening for CMV retinitis has been recommended only for patients with severe CD4+ lymphocyte depletion.1,2 In fact, a recent letter in The Journal of the American Medical Association2 claimed that "only patients whose CD4 count is below 0.10×109/L (100/μL) develop CMV retinitis." We describe two patients with human immunodeficiency virus (HIV) infection but no prior AIDS-defining diagnosis in whom CMV retinitis with CD4+ counts greater than 0.20×109/L developed.
See also pages 25 and 89
A 56-year-old HIV-seropositive homosexual man presented with progressive visual field loss in his left eye. His CD4+ lymphocyte count was 0.315× 109/L 1 month earlier, when he noted black spots in that eye but did not
Fekrat S, Dunn JP, Lee D, Miller T, Jabs DA. Cytomegalovirus Retinitis in HIV-Infected Patients With Elevated CD4+ Counts. Arch Ophthalmol. 1995;113(1):18. doi:10.1001/archopht.1995.01100010020007