I was pleased to see the Archives devote an issue (July 1996) to the ocular manifestations of the human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome. It might be of interest to your readers, however, to learn that 90% of HIV-infected individuals live in developing countries and that the ocular manifestations in these countries are different.
In sub-Saharan Africa, where approximately 65% of the world's HIV-infected population lives, cytomegalovirus is relatively rare.1,2 We have assumed that this is due to the fact that those infected with HIV die relatively shortly after becoming infected with the virus3 having relatively high CD4+ cell counts. There are also data that suggest that noninfectious retinopathy is less common there,1 which might be explained by differences in rheological factors between the populations. Whatever the reasons, cytomegalovirus retinitis is not a common clinical problem. The acquired immunodeficiency syndrome epidemic is, however, having
Lewallen S. Ocular Manifestations of the Human Immunodeficiency Virus and the Acquired Immunodeficiency Syndrome in Developing Countries. Arch Ophthalmol. 1997;115(3):435. doi:10.1001/archopht.1997.01100150437033