Despite several suggested theories, the pathogenesis of human immunodeficiency virus (HIV)-related retinal microangiopathy syndrome (MAPS), consisting of cotton-wool spots and retinal hemorrhages, is not yet understood. A direct endothelial cell infection,1 an immunocomplex vasculitis,2 and an increased serum concentration of endotheline3 have been considered as its possible origins.
Since January 1992 we have examined 125 patients with HIV infection using the Centers for Disease Control and Prevention (CDC) classification of HIV type 1 (HIV-1) infection (CDC 1 classified patients, 1; CDC 2, 47; CDC 3, 7; CDC 4, 70 [Table 1 ]). Fifty of these patients also tested positive for infection with hepatitis C virus (HCV) (CDC 1, 0 patients; CDC 2, 16; CDC 3, 4; CDC 4, 30). This high prevalence of infection with both HIV and HCV can be explained by an overproportional rate of injecting drug users. None of our patients had been subjected to