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Photo Essay
May 1999

HIV-Related Occlusive Vasculitis

Arch Ophthalmol. 1999;117(5):696-698. doi:10.1001/archopht.117.5.696

WE REPORT 2 cases of extensive, bilateral retinal ischemia in human immunodeficiency virus (HIV) infection. We found no similar cases; HIV infection is usually associated either with mild microangiopathy or, more rarely, with isolated large-vessel occlusions.

A 21-year-old woman had painless loss of visual acuity in the right eye over several weeks. Visual acuity was 1/200 OD and 20/20 OS with a relative afferent pupillary defect. Funduscopic examination showed a severely ischemic right eye (Figure 1) and a normal left fundus. Magnetic resonance imaging of the brain and magnetic resonance angiography of the carotid arteries showed no abnormalities, except for sinusitis. The patient refused blood tests.